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Guan X, Zheng W, Fan K, Han X, Hu B, Li X, Yan Z, Lu Z, Gong J. Structural and functional changes following brain surgery in pediatric patients with intracranial space-occupying lesions. Brain Imaging Behav 2024; 18:710-719. [PMID: 38376714 DOI: 10.1007/s11682-023-00799-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 02/21/2024]
Abstract
We explored the structural and functional changes of the healthy hemisphere of the brain after surgery in children with intracranial space-occupying lesions. We enrolled 32 patients with unilateral intracranial space-occupying lesions for brain imaging and cognitive assessment. Voxel-based morphometry and surface-based morphometry analyses were used to investigate the structural images of the healthy hemisphere. Functional images were analyzed using regional homogeneity, amplitude of low-frequency fluctuations, and fractional-amplitude of low-frequency fluctuations. Voxel-based morphometry and surface-based morphometry analysis used the statistical model built into the CAT 12 toolbox. Paired t-tests were used for functional image and cognitive test scores. For structural image analysis, we used family-wise error correction of peak level (p < 0.05), and for functional image analysis, we use Gaussian random-field theory correction (voxel p < 0.001, cluster p < 0.05). We found an increase in gray matter volume in the healthy hemisphere within six months postoperatively, mainly in the frontal lobe. Regional homogeneity and fractional-amplitude of low-frequency fluctuations also showed greater functional activity in the frontal lobe. The results of cognitive tests showed that psychomotor speed and motor speed decreased significantly after surgery, and reasoning increased significantly after surgery. We concluded that in children with intracranial space-occupying lesions, the healthy hemisphere exhibits compensatory structural and functional effects within six months after surgery. This effect occurs mainly in the frontal lobe and is responsible for some higher cognitive compensation. This may provide some guidance for the rehabilitation of children after brain surgery.
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Affiliation(s)
- Xueyi Guan
- Department of Pediatric Neurosurgery Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Wenjian Zheng
- Department of Pediatric Neurosurgery Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Kaiyu Fan
- Department of Pediatric Neurosurgery Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Xu Han
- Department of Pediatric Neurosurgery Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Bohan Hu
- Department of Pediatric Neurosurgery Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Xiang Li
- Department of Pediatric Neurosurgery Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Zihan Yan
- Department of Pediatric Neurosurgery Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Zheng Lu
- Department of Pediatric Neurosurgery Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Jian Gong
- Department of Pediatric Neurosurgery Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
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Herbet G, Duffau H, Mandonnet E. Predictors of cognition after glioma surgery: connectotomy, structure-function phenotype, plasticity. Brain 2024; 147:2621-2635. [PMID: 38573324 DOI: 10.1093/brain/awae093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/19/2024] [Accepted: 03/09/2024] [Indexed: 04/05/2024] Open
Abstract
Determining preoperatively the maximal extent of resection that would preserve cognitive functions is the core challenge of brain tumour surgery. Over the past decade, the methodological framework to achieve this goal has been thoroughly renewed: the population-level topographically-focused voxel-based lesion-symptom mapping has been progressively overshadowed by machine learning (ML) algorithmics, in which the problem is framed as predicting cognitive outcomes in a patient-specific manner from a typically large set of variables. However, the choice of these predictors is of utmost importance, as they should be both informative and parsimonious. In this perspective, we first introduce the concept of connectotomy: instead of parameterizing resection topography through the status (intact/resected) of a huge number of voxels (or parcels) paving the whole brain in the Cartesian 3D-space, the connectotomy models the resection in the connectivity space, by computing a handful number of networks disconnection indices, measuring how the structural connectivity sustaining each network of interest was hit by the resection. This connectivity-informed reduction of dimensionality is a necessary step for efficiently implementing ML tools, given the relatively small number of patient-examples in available training datasets. We further argue that two other major sources of interindividual variability must be considered to improve the accuracy with which outcomes are predicted: the underlying structure-function phenotype and neuroplasticity, for which we provide an in-depth review and propose new ways of determining relevant predictors. We finally discuss the benefits of our approach for precision surgery of glioma.
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Affiliation(s)
- Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier 34090, France
- Praxiling lab, UMR5267 CNRS & Paul Valéry University, Montpellier 34090, France
- Department of Medicine, University of Montpellier, Montpellier 34090, France
- Institut Universitaire de France, Paris 75000, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier 34090, France
- Department of Medicine, University of Montpellier, Montpellier 34090, France
- Team 'Plasticity of Central Nervous System, Stem Cells and Glial Tumors', U1191 Laboratory, Institute of Functional Genomics, National Institute for Health and Medical Research (INSERM), University of Montpellier, Montpellier 34000, France
| | - Emmanuel Mandonnet
- Department of Neurosurgery, Lariboisière Hospital, AP-HP, Paris 75010, France
- Frontlab, CNRS UMR 7225, INSERM U1127, Paris Brain Institute (ICM), Paris 75013, France
- Université de Paris Cité, UFR de médecine, Paris 75005, France
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Ng S, Moritz-Gasser S, Lemaitre AL, Duffau H, Herbet G. Multivariate mapping of low-resilient neurocognitive systems within and around low-grade gliomas. Brain 2024; 147:2718-2731. [PMID: 38657204 DOI: 10.1093/brain/awae130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 03/18/2024] [Accepted: 04/05/2024] [Indexed: 04/26/2024] Open
Abstract
Accumulating evidence suggests that the brain exhibits a remarkable capacity for functional compensation in response to neurological damage, a resilience potential that is deeply rooted in the malleable features of its underlying anatomofunctional architecture. This propensity is particularly exemplified by diffuse low-grade glioma, a subtype of primary brain tumour. However, functional plasticity is not boundless, and surgical resections directed at structures with limited neuroplasticity can lead to incapacitating impairments. Yet, maximizing diffuse low-grade glioma resections offers substantial oncological benefits, especially when the resection extends beyond the tumour margins (i.e. supra-tumour or supratotal resection). In this context, the primary objective of this study was to identify which cerebral structures were associated with less favourable cognitive outcomes after surgery, while accounting for intra-tumour and supra-tumour features of the surgical resections. To achieve this objective, we leveraged a unique cohort of 400 patients with diffuse low-grade glioma who underwent surgery with awake cognitive mapping. Patients benefitted from a neuropsychological assessment consisting of 18 subtests administered before and 3 months after surgery. We analysed changes in performance and applied topography-focused and disconnection-focused multivariate lesion-symptom mapping using support vector regressions, in an attempt to capture resected cortico-subcortical structures less amenable to full cognitive compensation. The observed changes in performance were of a limited magnitude, suggesting an overall recovery (13 of 18 tasks recovered fully despite a mean resection extent of 92.4%). Nevertheless, lesion-symptom mapping analyses revealed that a lack of recovery in picture naming was linked to damage in the left inferior temporal gyrus and inferior longitudinal fasciculus. Likewise, for semantic fluency abilities, an association was established with damage to the left precuneus/posterior cingulate. For phonological fluency abilities, the left dorsomedial frontal cortex and the frontal aslant tract were implicated. Moreover, difficulties in spatial exploration were associated with injury to the right dorsomedial prefrontal cortex and its underlying connectivity. An exploratory analysis suggested that supra-tumour resections were associated with a less pronounced recovery following specific resection patterns, such as supra-tumour resections of the left uncinate fasciculus (picture naming), the left corticostriatal tract and the anterior corpus callosum (phonological fluency), the hippocampus and parahippocampus (episodic memory) and the right frontal-mesial areas (visuospatial exploration). Collectively, these patterns of results shed new light on both low-resilient neural systems and the prediction of cognitive recovery following glioma surgery. Furthermore, they indicate that supra-tumour resections were only occasionally less well tolerated from a cognitive viewpoint. In doing so, they have deep implications for surgical planning and rehabilitation strategies.
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Affiliation(s)
- Sam Ng
- Département de Neurochirurgie, Hôpital Gui de Chauliac, Centre Hospitalier Universitaire de Montpellier, 34090 Montpellier, France
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, 34094 Montpellier, France
| | - Sylvie Moritz-Gasser
- Département de Neurochirurgie, Hôpital Gui de Chauliac, Centre Hospitalier Universitaire de Montpellier, 34090 Montpellier, France
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, 34094 Montpellier, France
| | - Anne-Laure Lemaitre
- Département de Neurochirurgie, Hôpital Gui de Chauliac, Centre Hospitalier Universitaire de Montpellier, 34090 Montpellier, France
- Laboratoire Praxiling, UMR 5267, CNRS, Université Paul Valéry-Montpellier 3, Bâtiment de recherche Marc Bloch, 34090 Montpellier, France
| | - Hugues Duffau
- Département de Neurochirurgie, Hôpital Gui de Chauliac, Centre Hospitalier Universitaire de Montpellier, 34090 Montpellier, France
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, 34094 Montpellier, France
| | - Guillaume Herbet
- Département de Neurochirurgie, Hôpital Gui de Chauliac, Centre Hospitalier Universitaire de Montpellier, 34090 Montpellier, France
- Laboratoire Praxiling, UMR 5267, CNRS, Université Paul Valéry-Montpellier 3, Bâtiment de recherche Marc Bloch, 34090 Montpellier, France
- Faculté de médecine, campus ADV, Université de Montpellier, 34090 Montpellier, France
- Institut Universitaire de France, 75231 Paris CEDEX 05, France
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He Q, Yang Z, Xue B, Song X, Zhang C, Yin C, Li Z, Deng Z, Sun S, Qiao H, Xie J, Hou Z. Epilepsy alters brain networks in patients with insular glioma. CNS Neurosci Ther 2024; 30:e14805. [PMID: 38887197 PMCID: PMC11183176 DOI: 10.1111/cns.14805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/13/2024] [Accepted: 05/30/2024] [Indexed: 06/20/2024] Open
Abstract
AIMS We intend to elucidate the alterations of cerebral networks in patients with insular glioma-related epilepsy (GRE) based on resting-state functional magnetic resonance images. METHODS We collected 62 insular glioma patients, who were subsequently categorized into glioma-related epilepsy (GRE) and glioma with no epilepsy (GnE) groups, and recruited 16 healthy individuals matched to the patient's age and gender to form the healthy control (HC) group. Graph theoretical analysis was applied to reveal differences in sensorimotor, default mode, visual, and executive networks among different subgroups. RESULTS No significant alterations in functional connectivity were found in either hemisphere insular glioma. Using graph theoretical analysis, differences were found in visual, sensorimotor, and default mode networks (p < 0.05). When the glioma located in the left hemisphere, the degree centrality was reduced in the GE group compared to the GnE group. When the glioma located in the right insula, the degree centrality, nodal efficiency, nodal local efficiency, and nodal clustering coefficient of the GE group were lower than those of the GnE group. CONCLUSION The impact of insular glioma itself and GRE on the brain network is widespread. The networks altered by insular GRE differ depending on the hemisphere location. GRE reduces the nodal properties of brain networks than that in insular glioma.
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Affiliation(s)
- Qifeng He
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Zuocheng Yang
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - BoWen Xue
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Xinyu Song
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Chuanhao Zhang
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - ChuanDong Yin
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Zhenye Li
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Zhenghai Deng
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Shengjun Sun
- Department of Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- Department of Radiology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Hui Qiao
- Department of Neurophysiology, Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina
| | - Jian Xie
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Zonggang Hou
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
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Guo Y, Bao H, Wei Z, Fang S, Jiang T, Wang Y. Structural changes in eloquent cortex secondary to glioma in sensorimotor area. Hum Brain Mapp 2024; 45:e26723. [PMID: 38864296 PMCID: PMC11167403 DOI: 10.1002/hbm.26723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/13/2024] [Accepted: 05/08/2024] [Indexed: 06/13/2024] Open
Abstract
This study aims to investigate the structural reorganization in the sensorimotor area of the brain in patients with gliomas, distinguishing between those with impaired and unimpaired strength. Using voxel-based morphometry (VBM) and region of interest (ROI) analysis, gray matter volumes (GMV) were compared in the contralesional primary motor gyrus, primary sensory gyrus, premotor area, bilateral supplementary motor area, and medial Brodmann area 8 (BA8). The results revealed that in patients with right hemisphere gliomas, the right medial BA8 volume was significantly larger in the impaired group than in the unimpaired group, with both groups exceeding the volume in 16 healthy controls (HCs). In patients with left hemisphere gliomas, the right supplementary motor area (SMA) was more pronounced in the impaired group compared to the unimpaired group, and both groups were greater than HCs. Additionally, the volumes of the right medial BA8 in both the impaired group were greater than HCs. Contralateral expansions in the gray matter of hand- and trunk-related cortices of the premotor area, precentral gyrus, and postcentral gyrus were observed compared to HCs. Furthermore, a negative correlation was found between hand Medical Research Council (MRC) score and volumes of the contralateral SMA and bilateral medial BA8. Notably, our findings reveal consistent results across both analytical approaches in identifying significant structural reorganizations within the sensorimotor cortex. These consistent findings underscore the adaptive neuroplastic responses to glioma presence, highlighting potential areas of interest for further neurosurgical planning and rehabilitation strategies.
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Affiliation(s)
- Yuhao Guo
- Department of Molecular Neuropathology, Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Hongbo Bao
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- Department of NeurosurgeryHarbin Medical University Cancer HospitalHarbinChina
| | - Zhishuo Wei
- Department of Neurological SurgeryUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
| | - Shengyu Fang
- Department of Molecular Neuropathology, Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Tao Jiang
- Department of Molecular Neuropathology, Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- Research Unit of Accurate Diagnosis, Treatment, and Translational Medicine of Brain TumorsChinese Academy of Medical SciencesBeijingChina
| | - Yinyan Wang
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
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Ng S, Duffau H, Herbet G. Perspectives in human brain plasticity sparked by glioma invasion: from intraoperative (re)mappings to neural reconfigurations. Neural Regen Res 2024; 19:947-948. [PMID: 37862182 PMCID: PMC10749607 DOI: 10.4103/1673-5374.382246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/25/2023] [Accepted: 07/18/2023] [Indexed: 10/22/2023] Open
Affiliation(s)
- Sam Ng
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- Praxiling Laboratory, UMR5267, CNRS, Paul Valéry- Montpellier 3 University, Montpellier, France
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Zhang S, Chen D, Sun H, Kemp GJ, Chen Y, Tan Q, Yang Y, Gong Q, Yue Q. Whole brain morphologic features improve the predictive accuracy of IDH status and VEGF expression levels in gliomas. Cereb Cortex 2024; 34:bhae151. [PMID: 38642107 DOI: 10.1093/cercor/bhae151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/14/2024] [Accepted: 03/23/2024] [Indexed: 04/22/2024] Open
Abstract
Glioma is a systemic disease that can induce micro and macro alternations of whole brain. Isocitrate dehydrogenase and vascular endothelial growth factor are proven prognostic markers and antiangiogenic therapy targets in glioma. The aim of this study was to determine the ability of whole brain morphologic features and radiomics to predict isocitrate dehydrogenase status and vascular endothelial growth factor expression levels. This study recruited 80 glioma patients with isocitrate dehydrogenase wildtype and high vascular endothelial growth factor expression levels, and 102 patients with isocitrate dehydrogenase mutation and low vascular endothelial growth factor expression levels. Virtual brain grafting, combined with Freesurfer, was used to compute morphologic features including cortical thickness, LGI, and subcortical volume in glioma patient. Radiomics features were extracted from multiregional tumor. Pycaret was used to construct the machine learning pipeline. Among the radiomics models, the whole tumor model achieved the best performance (accuracy 0.80, Area Under the Curve 0.86), while, after incorporating whole brain morphologic features, the model had a superior predictive performance (accuracy 0.82, Area Under the Curve 0.88). The features contributed most in predicting model including the right caudate volume, left middle temporal cortical thickness, first-order statistics, shape, and gray-level cooccurrence matrix. Pycaret, based on morphologic features, combined with radiomics, yielded highest accuracy in predicting isocitrate dehydrogenase mutation and vascular endothelial growth factor levels, indicating that morphologic abnormalities induced by glioma were associated with tumor biology.
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Affiliation(s)
- Simin Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan 610041, China
| | - Di Chen
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Huaiqiang Sun
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre (LiMRIC) and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 7ZX, United Kingdom
| | - Yinying Chen
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Qiaoyue Tan
- Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Yuan Yang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
- Huaxi Glioma Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Qiyong Gong
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Sichuan 610041, China
| | - Qiang Yue
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
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Zhang S, Yang X, Tan Q, Sun H, Chen D, Chen Y, Zhang H, Yang Y, Gong Q, Yue Q. Cortical myelin and thickness mapping provide insights into whole-brain tumor burden in diffuse midline glioma. Cereb Cortex 2024; 34:bhad491. [PMID: 38112602 PMCID: PMC10793579 DOI: 10.1093/cercor/bhad491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/21/2023] Open
Abstract
Systemic infiltration is a hallmark of diffuse midline glioma pathogenesis, which can trigger distant disturbances in cortical structure. However, the existence and effects of these changes have been underexamined. This study aimed to investigate whole-brain cortical myelin and thickness alternations induced by diffuse midline glioma. High-resolution T1- and T2-weighted images were acquired from 90 patients with diffuse midline glioma with H3 K27-altered and 64 patients with wild-type and 86 healthy controls. Cortical thickness and myelin content was calculated using Human Connectome Project pipeline. Significant differences in cortical thickness and myelin content were detected among groups. Short-term survival prediction model was constructed using automated machine learning. Compared with healthy controls, diffuse midline glioma with H3 K27-altered patients showed significantly reduced cortical myelin in bilateral precentral gyrus, postcentral gyrus, insular, parahippocampal gyrus, fusiform gyrus, and cingulate gyrus, whereas diffuse midline glioma with H3 K27 wild-type patients exhibited well-preserved myelin content. Furtherly, when comparing diffuse midline glioma with H3 K27-altered and diffuse midline glioma with H3 K27 wild-type, the decreased cortical thickness in parietal and occipital regions along with demyelination in medial orbitofrontal cortex was observed in diffuse midline glioma with H3 K27-altered. Notably, a combination of cortical features and tumor radiomics allowed short-term survival prediction with accuracy 0.80 and AUC 0.84. These findings may aid clinicians in tailoring therapeutic approaches based on cortical characteristics, potentially enhancing the efficacy of current and future treatment modalities.
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Affiliation(s)
- Simin Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610072, China
| | - Xibiao Yang
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu 610041, China
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Qiaoyue Tan
- Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Huaiqiang Sun
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610072, China
| | - Di Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610072, China
| | - Yinying Chen
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Hongjing Zhang
- Huaxi Glioma Center, West China Hospital of Sichuan University, Chengdu 610041, China
- Department of Radiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610065, China
| | - Yuan Yang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen 610041, China
| | - Qiang Yue
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
- Huaxi Glioma Center, West China Hospital of Sichuan University, Chengdu 610041, China
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9
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Cargnelutti E, Maieron M, D'Agostini S, Ius T, Skrap M, Tomasino B. Preoperative plasticity in the functional naming network of patients with left insular gliomas. Neuroimage Clin 2023; 41:103561. [PMID: 38176362 PMCID: PMC10797139 DOI: 10.1016/j.nicl.2023.103561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/22/2023] [Accepted: 12/27/2023] [Indexed: 01/06/2024]
Abstract
Plasticity could take place as a compensatory process following brain glioma growth. Only a few studies specifically explored plasticity in patients affected by a glioma invading the left insula; even more, plasticity of the insular cortex in task-based functional language network is almost unexplored. In the current study, we explored potential plasticity in a consecutive series of 22 patients affected by a glioma centered to the left insula, by comparing their preoperative object-naming functional network with that of a group of healthy controls. After having controlled for demographic variables, fMRI results showed that patients vs. controls activated a cluster in the right, contralesional pars triangularis including the Broca's area. On the other hand, controls did not significantly activate any brain region more than patients. At behavioral level, patients retained a generally preserved naming performance as well as a proficient language processing profile. These findings suggest that involvement of language-specific areas in the healthy hemisphere could help compensate for the left, affected insula, thus allowing preservation of the naming functions. Results are commented in relation to lesion site, naming performance, and potential relevance for neurosurgery.
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Affiliation(s)
- Elisa Cargnelutti
- Scientific Institute IRCCS "Eugenio Medea", Dipartimento/Unità Operativa Pasian di Prato, 33037 Pasian di Prato, Italy
| | - Marta Maieron
- Department of Physics, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy
| | - Serena D'Agostini
- Neuroradiology Unit, Department of Diagnostic Imaging, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy
| | - Tamara Ius
- Neurosurgery Unit, Head-Neck and Neurosciences Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy
| | - Miran Skrap
- Neurosurgery Unit, Head-Neck and Neurosciences Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy
| | - Barbara Tomasino
- Scientific Institute IRCCS "Eugenio Medea", Dipartimento/Unità Operativa Pasian di Prato, 33037 Pasian di Prato, Italy.
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Kinno R, Muragaki Y, Maruyama T, Tamura M, Ono K, Tanaka K, Sakai KL. Diffuse glioma-induced structural reorganization in close association with preexisting syntax-related networks. Cortex 2023; 167:283-302. [PMID: 37586138 DOI: 10.1016/j.cortex.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 06/16/2023] [Accepted: 07/14/2023] [Indexed: 08/18/2023]
Abstract
Glioma in the left frontal cortex has been reported to cause agrammatic comprehension and induce global functional connectivity alterations within the syntax-related networks. However, it remains unclear to what extent the structural reorganization is affected by preexisting syntax-related networks. We examined 28 patients with a diffuse glioma in the left hemisphere and 23 healthy participants. Syntactic abilities were assessed by a picture-sentence matching task with various sentence types. The lesion responsible for agrammatic comprehension was identified by region-of-interest-based lesion-symptom mapping (RLSM). Cortical structural alterations were examined by surface-based morphometry (SBM), in which the cortical thickness and fractal dimension were measured with three-dimensional magnetic resonance imaging (MRI). Fiber tracking on the human population-averaged diffusion MRI template was performed to examine whether the cortical structural alterations were associated with the syntax-related networks. The RLSM revealed associations between agrammatic comprehension and a glioma in the posterior limb of the left internal capsule. The SBM demonstrated that decreased cortical thickness and/or increased complexity of the right posterior insula were associated not only with agrammatic comprehension of the patients but also with the syntactic abilities of healthy participants. The fiber tracking revealed that the route between these two regions was anatomically integrated into the preexisting syntax-related networks previously identified. These results suggest a potential association between agrammatic comprehension in patients with diffuse glioma and structural variations in specific tracts and cortical regions, which may be closely related to the syntax-related networks.
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Affiliation(s)
- Ryuta Kinno
- Department of Basic Science, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan; Division of Neurology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan.
| | - Yoshihiro Muragaki
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Takashi Maruyama
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Manabu Tamura
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Kenjiro Ono
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan; Department of Neurology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Kyohei Tanaka
- Department of Basic Science, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Kuniyoshi L Sakai
- Department of Basic Science, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
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11
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Zhang S, Sun H, Yang X, Wan X, Tan Q, Li S, Shao H, Su X, Yue Q, Gong Q. An MRI Study Combining Virtual Brain Grafting and Surface-Based Morphometry Analysis to Investigate Contralateral Alterations in Cortical Morphology in Patients With Diffuse Low-Grade Glioma. J Magn Reson Imaging 2023; 58:741-749. [PMID: 36524459 DOI: 10.1002/jmri.28562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND The human brain has ability to reorganize itself in response to glioma. However, the mechanism of cortical reorganization remains unclear. PURPOSE To investigate alterations in cortical thickness and local gyration index (LGI) in patients with unilateral frontal lobe diffuse low-grade glioma (DLGG). STUDY TYPE Retrospective. SUBJECTS Ninety-nine patients with histopathologically proven DLGG invading the left frontal lobe (LF; N = 56) or the right frontal lobe (RF; N = 43), and healthy controls (HC; N = 53). FIELD STRENGTH/SEQUENCE 3.0 T, 3D T1-weighted images and gadolinium enhanced T1-weighted images using magnetization-prepared rapid gradient echo sequence, T2-weighted images, and fluid-attenuated inversion recovery using turbo spin echo sequence. ASSESSMENT In patients with DLGG, virtual brain grafting combined with Freesurfer was utilized to enable automated cortical thickness and LGI calculation. In HC, standard FreeSurfer pipeline was applied to calculate these measures. Radiomic features were extracted from glioma using Pyradiomic software. STATISTICAL TESTS General linear model and Pearson's correlation analysis. A P value <0.05 was considered statistically significant. RESULTS For LF patients, there was significantly increased cortical thickness in the rostral middle frontal gyrus, significantly reduced cortical thickness in the precentral gyrus and hypogyrification in the lingual and medial orbitofrontal (MOF) gyrus in contralateral hemisphere. For RF patients, there was significantly increased cortical thickness in the middle temporal, lateral occipital extending to isthmus cingulate gyrus, significantly reduced cortical thickness in the precentral gyrus and hypogyrification in the lingual gyrus in the contralateral hemisphere. A negative association between four textural features of DLGG and LGI in the right MOF gyrus of LF group was found (r = -0.609, -0.442, -0.545, and -0.417, respectively). DATA CONCLUSION Cortical thickness compensation was shown in contralateral homotopic location and some distant contralateral regions. Additionally, there was decreased cortical thickness in the contralateral precentral gyrus and hypogyrification in contralateral lingual gyrus. EVIDENCE LEVEL 4 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Simin Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Huaxi Glioma Center, West China Hospital of Sichuan University, Chengdu, China
| | - Huaiqiang Sun
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xibiao Yang
- Huaxi Glioma Center, West China Hospital of Sichuan University, Chengdu, China
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xinyue Wan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - QiaoYue Tan
- Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Shuang Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Huaxi Glioma Center, West China Hospital of Sichuan University, Chengdu, China
| | - Hanbin Shao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Huaxi Glioma Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaorui Su
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, china
| | - Qiang Yue
- Huaxi Glioma Center, West China Hospital of Sichuan University, Chengdu, China
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qiyong Gong
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China
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12
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Liu D, Chen J, Ge H, Yan Z, Luo B, Hu X, Yang K, Liu Y, Xiao C, Zhang W, Liu H. Structural plasticity of the contralesional hippocampus and its subfields in patients with glioma. Eur Radiol 2023; 33:6107-6115. [PMID: 37036480 DOI: 10.1007/s00330-023-09582-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/14/2022] [Accepted: 02/17/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVES To characterize the structural plasticity of the contralesional hippocampus and its subfields in patients with unilateral glioma. METHODS 3D T1-weighted MRI images were collected from 55 patients with tumors infiltrating the left (HipL, n = 27) or right (HipR, n = 28) hippocampus, along with 30 age- and sex-matched healthy controls (HC). Gray matter volume differences of the contralesional hippocampal regions and three control regions (superior frontal gyrus, caudate nucleus, and superior occipital gyrus) were evaluated using voxel-based morphometry (VBM) analyses. Volumetric differences in the hippocampus and its subregional volume were measured using the FreeSurfer software. RESULTS Compared with HC, patients with unilateral hippocampal glioma exhibited significantly larger gray matter volume in the contralesional hippocampus and parahippocampal regions (cluster = 571 voxels for HipL; cluster 1 = 538 voxels and cluster 2 = 88 voxels for HipR; family-wise error corrected p < 0.05). No significant alterations were found in control regions. Volumetric analyses showed the same trend in the contralesional hippocampal subregions for both patient groups, including the CA1 head, CA3 head, hippocampus amygdala transition area (HATA), fimbria, and the granule cell molecular layer of the dentate gyrus head (GC-ML-DG head). Notably, the differences of the contralesional HATA (HipL: η2 = 0.418, corrected p = 0.002; HipR: η2 = 0.313, corrected p = 0.052) and fimbria (HipL: η2 = 0.450, corrected p < 0.001; HipR: η2 = 0.358, corrected p = 0.012) still held after the Bonferroni correction. CONCLUSIONS Our findings provide evidence for macrostructural plasticity of the contralateral hippocampus in patients with unilateral hippocampal glioma. Specifically, HATA and fimbria exhibit great potential in this process. KEY POINTS • Glioma infiltration of the hippocampal regions induces a significant increase in gray matter volume on the contralateral side. • Specifically, the HATA and fimbria regions exhibit favorable plastic potential in the process of lesion-induced structural remolding.
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Affiliation(s)
- Dongming Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, 210029, Jiangsu, China
| | - Jiu Chen
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
- Institute of Brain Sciences, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Honglin Ge
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, 210029, Jiangsu, China
| | - Zhen Yan
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, 210029, Jiangsu, China
| | - Bei Luo
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, 210029, Jiangsu, China
| | - Xinhua Hu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, 210029, Jiangsu, China
- Institute of Brain Sciences, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Kun Yang
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, 210029, Jiangsu, China
| | - Yong Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, 210029, Jiangsu, China
| | - Chaoyong Xiao
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wenbin Zhang
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, 210029, Jiangsu, China.
- Institute of Brain Sciences, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
| | - Hongyi Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, 210029, Jiangsu, China.
- Institute of Brain Sciences, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
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Manso-Ortega L, De Frutos-Sagastuy L, Gisbert-Muñoz S, Salamon N, Qiao J, Walshaw P, Quiñones I, Połczyńska MM. Grey Matter Reshaping of Language-Related Regions Depends on Tumor Lateralization. Cancers (Basel) 2023; 15:3852. [PMID: 37568668 PMCID: PMC10417790 DOI: 10.3390/cancers15153852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/12/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
A brain tumor in the left hemisphere can decrease language laterality as assessed through fMRI. However, it remains unclear whether or not this decreased language laterality is associated with a structural reshaping of the grey matter, particularly within the language network. Here, we examine if the disruption of the language hubs exclusively affects the macrostructural properties of the contralateral homologues or whether it affects both hemispheres. This study uses voxel-based morphometry applied to high-resolution MR T1-weighted MPRAGE images from 31 adult patients' left hemisphere, which is dominant for language. Eighteen patients had brain tumors in the left hemisphere, and thirteen had tumors in the right hemisphere. A cohort of 71 healthy individuals matched with respect to age and sex was used as a baseline. We defined 10 ROIs per hemisphere involved in language function. Two separate repeated-measure ANOVAs were conducted with the volume per region as the dependent variable. For the patients, tumor lateralization (right versus left) served as a between-subject factor. The current study demonstrated that the presence of a brain tumor generates global volumetric changes affecting the left language regions and their contralateral homologues. These changes are mediated by the lateralization of the lesion. Our findings suggest that functional mechanisms are supported by the rearrangement of the grey matter.
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Affiliation(s)
- Lucía Manso-Ortega
- Neurobiology of Language Group, Basque Center on Cognition, Brain and Language (BCBL), 20009 Donostia-San Sebastián, Spain; (L.D.F.-S.); (S.G.-M.)
- Department of Basque Language and Communication, University of the Basque Country, UPV/EHU, 48940 Bilbao, Spain
| | - Laura De Frutos-Sagastuy
- Neurobiology of Language Group, Basque Center on Cognition, Brain and Language (BCBL), 20009 Donostia-San Sebastián, Spain; (L.D.F.-S.); (S.G.-M.)
| | - Sandra Gisbert-Muñoz
- Neurobiology of Language Group, Basque Center on Cognition, Brain and Language (BCBL), 20009 Donostia-San Sebastián, Spain; (L.D.F.-S.); (S.G.-M.)
- Department of Basque Language and Communication, University of the Basque Country, UPV/EHU, 48940 Bilbao, Spain
| | - Noriko Salamon
- Department of Radiology, University of California, Los Angeles, CA 92093, USA; (N.S.); (J.Q.)
| | - Joe Qiao
- Department of Radiology, University of California, Los Angeles, CA 92093, USA; (N.S.); (J.Q.)
| | - Patricia Walshaw
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 92093, USA; (P.W.); (M.M.P.)
| | - Ileana Quiñones
- Neurobiology of Language Group, Basque Center on Cognition, Brain and Language (BCBL), 20009 Donostia-San Sebastián, Spain; (L.D.F.-S.); (S.G.-M.)
- IKERBASQUE, Basque Foundation for Science, Plaza Euskadi 5, 48009 Bilbao, Spain
| | - Monika M. Połczyńska
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 92093, USA; (P.W.); (M.M.P.)
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14
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Ng S, Duffau H. Brain Plasticity Profiling as a Key Support to Therapeutic Decision-Making in Low-Grade Glioma Oncological Strategies. Cancers (Basel) 2023; 15:3698. [PMID: 37509359 PMCID: PMC10378506 DOI: 10.3390/cancers15143698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
The ability of neural circuits to compensate for damage to the central nervous system is called postlesional plasticity. In diffuse low-grade gliomas (LGGs), a crosstalk between the brain and the tumor activates modulations of plasticity, as well as tumor proliferation and migration, by means of paracrine and electrical intercommunications. Such adaptative mechanisms have a major impact on the benefits and risks of oncological treatments but are still disregarded by current neuro-oncological guidelines. In this review, the authors first aimed to highlight clinical, radiological, and oncological markers that robustly reflect the plasticity potentials and limitations in LGG patients, including the location of the tumor and the degree of critical white matter tract infiltration, the velocity of tumor expansion, and the reactional changes of neuropsychological performances over time. Second, the interactions between the potential/limitations of cerebral plasticity and the efficacy/tolerance of treatment options (i.e., surgery, chemotherapy, and radiotherapy) are reviewed. Finally, a longitudinal and multimodal treatment approach accounting for the evolutive profiles of brain plasticity is proposed. Such an approach integrates personalized predictive models of plasticity potentials with a step-by-step therapeutic decision making and supports onco-functional balanced strategies in patients with LGG, with the ultimate aim of optimizing overall survival and quality of life.
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Affiliation(s)
- Sam Ng
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295 Montpellier, France
- Institute of Functional Genomics, University of Montpellier, Centre National de le Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale 1191, 34094 Montpellier, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295 Montpellier, France
- Institute of Functional Genomics, University of Montpellier, Centre National de le Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale 1191, 34094 Montpellier, France
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15
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Chang WH, Wei KC, Chen PY, Chen YC, Wu YY, Tsai HC, Chen MH, Chao YP, Chen KT. The impact of patient factors and tumor characteristics on language neuroplasticity in left hemispheric diffuse gliomas prior to surgical resection. J Neurooncol 2023; 163:95-104. [PMID: 37093525 DOI: 10.1007/s11060-023-04311-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/07/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE Language networks are reorganized during glioma growth, leading to varying language performance in patients with gliomas located in or around language-eloquent areas. Therefore, pre-treated language performance reflects the neuroplasticity potential. Different domains of language processing, such as speech expression, repetition, and comprehension, involving different neural networks. We analyzed the effects of patient factors and tumor characteristics on the pre-treated performance to investigate neuroplastic potential of different language domains. METHODS Patient age, sex, education level, tumor grade, language pathway involvement, T1 contrast enhanced (C+), and FLAIR (T2) volume were selected as variables. The correlation with abnormal language performance was verified using univariate and multivariate logistic regression. RESULTS In total, 104 left hemispheric glioma patients were enrolled in this study. 44% of patients had repetitive abnormalities, 34.9% had comprehensive abnormalities, and 32.1% had expressive abnormalities. The proportion of normal language performance was 60% in grade 2 and 3 gliomas and 16% in grade 4 gliomas. Tumor grade (p = 0.006) and T2 volume (p = 0.008) were associated with abnormal performance in the expressive domain, education level (p = 0.004) and T1 C+ volume (p = 0.049) in the repetitive domain, and education level (p = 0.013), T2 volume (p = 0.011), and tumor grade (p = 0.089) in the comprehensive domain. CONCLUSION Different clinical and radiological factors affected the abnormal performance of the three language domains, indicating their functional connectivity and neuroplastic potential are inherently varied. The dynamic interactions between patient factors, tumor characteristics, and language processing should be considered when resecting left hemispheric gliomas.
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Affiliation(s)
- Wei-Han Chang
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Keelung, New Taipei, Taiwan
- Department of Nutrition and Health Sciences, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Kuo-Chen Wei
- Department of Neurosurgery, New Taipei Municipal TuCheng Hospital, Chang Gung Medical Foundation, New Taipei, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Pin-Yuan Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Neurosurgery, Chang Gung Memorial Hospital at Keelung, New Taipei, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yi-Chun Chen
- Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang-Gung University, Taoyuan, Taiwan
- Dementia Center, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yah-Yuan Wu
- Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang-Gung University, Taoyuan, Taiwan
- Dementia Center, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hong-Chieh Tsai
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan, 33305, Taiwan
| | - Mei-Hui Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yi-Ping Chao
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Ko-Ting Chen
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan.
- School of Medicine, Chang Gung University, Taoyuan, Taiwan.
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan, 33305, Taiwan.
- Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
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16
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Fang S, Li L, Weng S, Guo Y, Fan X, Jiang T, Wang Y. Altering patterns of sensorimotor network in patients with different pathological diagnoses and glioma-related epilepsy under the latest glioma classification of the central nervous system. CNS Neurosci Ther 2023; 29:1368-1378. [PMID: 36740245 PMCID: PMC10068458 DOI: 10.1111/cns.14109] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/16/2022] [Accepted: 01/20/2023] [Indexed: 02/07/2023] Open
Abstract
AIMS We aimed to clarify the relationship between alterations in functional networks and glioma-related epilepsy (GRE) in patients with different molecular diagnoses. METHODS We enrolled 160 patients with prefrontal gliomas and different histories of GRE. The patients were grouped based on the latest pathological glioma classification and GRE history. Graph theory analysis was applied to reveal alterations in the sensorimotor networks among various subgroups. Binary logistic regression was used to identify risk factors for preoperative GRE onset. RESULTS Decreasing shortest path length was found in patients with GRE, regardless of the chromosome 1p/19q status. Nodes located in the premotor and supplementary motor areas showed decreased nodal betweenness centrality and vulnerability in patients with GRE and chromosome 1p/19q intact. Additionally, the node on the primary motor area showed decreased nodal vulnerability but the node on the sensory-related thalamus increased in patients with GRE and chromosome 1p/19q co-deletion. Decreased shortest path length, grade 2, and decreased nodal betweenness centrality of the premotor area were risk factors for GRE. CONCLUSION Decreased shortest path length was a characteristic alteration in GRE and prefrontal glioma. Alterations in global properties were similar, but nodal properties were different in patients with GRE and different chromosome 1p/19q statuses.
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Affiliation(s)
- Shengyu Fang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Neurosurgical Institute, Beijing, China
| | - Lianwang Li
- Beijing Neurosurgical Institute, Beijing, China
| | | | - Yuhao Guo
- Beijing Neurosurgical Institute, Beijing, China
| | - Xing Fan
- Beijing Neurosurgical Institute, Beijing, China
| | - Tao Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Neurosurgical Institute, Beijing, China.,Research Unit of Accurate Diagnosis, Treatment, and Translational Medicine of Brain Tumors, Chinese Academy of Medical Sciences, Beijing, China
| | - Yinyan Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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17
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Manso-Ortega L, De Frutos-Sagastuy L, Gisbert- Muñoz S, Salamon N, Qiao J, Walshaw P, Quiñones I, Połczyńska MM. Grey matter reshaping of language-related regions depends on tumor lateralization. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.02.526219. [PMID: 36778417 PMCID: PMC9915653 DOI: 10.1101/2023.02.02.526219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
A brain tumor in the left hemisphere can decrease language laterality as assessed with fMRI. However, it remains unclear whether or not this decreased language laterality is associated with a structural reshaping of the grey matter, particularly within the language network. Here, we examine if the disruption of language hubs exclusively affects macrostructural properties of contralateral homologues (as suggested by previous research), or whether it affects both hemispheres. This study uses voxel-based morphometry applied to high-resolution MR T1-weighted MPRAGE images from 31 adult patients left-dominant for language. Eighteen patients had brain tumors in the left hemisphere, and 13 had tumors in the right hemisphere. A cohort of 71 healthy individuals matched on age and sex was used as a baseline. We defined 10 ROIs per hemisphere known to subserve language function. Two separate repeated-measures ANOVAs were conducted with the volume per region as the dependent variables. For the patients, tumor lateralization (right versus left) served as a between-subject factor. The current study demonstrated that the presence of a brain tumor generates a global volumetric change affecting left language regions and their contralateral homologues. These changes are mediated by the lateralization of the lesion. Our findings suggest that compensatory functional mechanisms are supported by the rearrangement of the grey matter, although future longitudinal research should determine the temporal course of such changes.
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Affiliation(s)
- Lucia Manso-Ortega
- Basque Center on Cognition, Brain and Language, BCBL, Donostia-San Sebastian, Spain
- University of the Basque Country, Bilbao, Spain
| | | | - Sandra Gisbert- Muñoz
- Basque Center on Cognition, Brain and Language, BCBL, Donostia-San Sebastian, Spain
- University of the Basque Country, Bilbao, Spain
| | - Noriko Salamon
- Dept. of Radiology, University of California, Los Angeles, USA
| | - Joe Qiao
- Dept. of Radiology, University of California, Los Angeles, USA
| | - Patricia Walshaw
- Dept. of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Ileana Quiñones
- Basque Center on Cognition, Brain and Language, BCBL, Donostia-San Sebastian, Spain
| | - Monika M. Połczyńska
- Dept. of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
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18
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Lv K, Cao X, Wang R, Lu Q, Wang J, Zhang J, Geng D. Contralesional macrostructural plasticity in patients with frontal low-grade glioma: a voxel-based morphometry study. Neuroradiology 2023; 65:297-305. [PMID: 36208304 DOI: 10.1007/s00234-022-03059-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/21/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE Neuroplasticity can partially compensate for the neurological deficits caused by brain tumors. However, the structural plasticity of the brain caused by brain tumors is not fully understood. This study aimed to assess the structural plasticity of the contralesional hemisphere in patients with frontal low-grade gliomas (LGGs). METHODS A total of 25 patients with left frontal LGGs (LFLGGs), 19 patients with right frontal LGGs (RFLGGs), and 25 healthy controls (HCs) were enrolled in this study. High-resolution structural T1-weighted imaging and fluid attenuation inversion recovery were performed on all participants. Voxel-based morphometry (VBM) analysis was used to detect differences in the brain structural plasticity between patients with unilateral LGGs and HCs. RESULTS VBM analysis revealed that compared with HCs, the gray matter volume (GMV) of the contralesional putamen and amygdala was significantly smaller and larger in the patients with RFLGGs and LFLGGs, respectively, while the GMVs of the contralesional cuneus and superior temporal gyrus (STG) were significantly larger in the patients with LFLGGs. The surviving clusters of the right hemisphere included 1357 voxels in the amygdala, 1680 voxels in the cuneus, 384 voxels in the STG, and 410 voxels in the putamen. The surviving clusters of the left hemisphere were 522 voxels in the amygdala and 320 voxels in the putamen. CONCLUSION The unilateral frontal LGGs are accompanied by structural plasticity in the contralesional cortex and vary with tumor laterality. Contralesional structural reorganization may be one of the physiological basis for functional reorganization or compensation in the frontal LGGs.
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Affiliation(s)
- Kun Lv
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Xin Cao
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Rong Wang
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Qingqing Lu
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China
- Department of Radiology, Ningbo First Hospital, Ningbo, China
| | - Jianhong Wang
- Department of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
| | - Jun Zhang
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
| | - Daoying Geng
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
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Pasquini L, Jenabi M, Peck KK, Holodny AI. Language reorganization in patients with left-hemispheric gliomas is associated with increased cortical volume in language-related areas and in the default mode network. Cortex 2022; 157:245-255. [PMID: 36356409 PMCID: PMC10201933 DOI: 10.1016/j.cortex.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/02/2022] [Accepted: 09/19/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Language function may reorganize to overcome focal impairment; however, the relation between functional and structural changes in patients with brain tumors remains unclear. We investigated the cortical volume of atypical language dominant (AD) patients with left frontal-insular high-grade (HGG) and low-grade glioma (LGG). We hypothesized atypical language being associated with areas of increased cortical volume in the right hemisphere, including language areas homologues. METHODS Patient were recruited following the criteria: left frontal-insular glioma; functional MRI and 3DT1-weighted images; no artifacts. We calculated an hemispheric language laterality index (LI), defined as: AD if LI < .2; left-dominant (LD) if LI ≥ .2. We measured cortical volume in three voxel-based morphometry (VBM) analyses: total AD vs. LD patients; AD vs. LD in HGG; AD vs. LD in LGG. We repeated the analysis in AD vs. LD healthy controls (HC). A minimum threshold of t > 2 and corrected p < .025 (Bonferroni) was employed. RESULTS We recruited 119 patients (44LGG, 75HGG). Hemispheric LI demonstrated 64/119AD and 55/119LD patients. The first VBM analysis demonstrated significantly increased cortical volume in AD patients in the right inferior frontal gyrus (IFG), right superior temporal gyrus (STG), right insula, right fusiform gyrus (FG), right precentral gyrus, right temporal-parietal junction, right posterior cingulate cortex (PCC), right hippocampus, right- and left cerebellum. AD patients with HGG showed the same areas of significantly increased cortical volume. AD patients with LGG displayed significantly increased cortical volume in right IFG, right STG, right insula, right FG, right anterior cingulate cortex, right PCC, right dorsal-lateral prefrontal cortex. HC showed no significant results. CONCLUSION Right-sided (atypical) language activations in patients with left-hemispheric gliomas are associated with areas of increased cortical volume. Additionally, default mode network nodes showed greater cortical volume in AD patients regardless of the tumor grade, supporting the idea of these cortices participating in the development of language plasticity.
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Affiliation(s)
- Luca Pasquini
- Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Neuroradiology Unit, NESMOS Department, Sant'Andrea Hospital, La Sapienza University, Rome 00189, Italy.
| | - Mehrnaz Jenabi
- Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Kyung K Peck
- Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Andrei I Holodny
- Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Brain Tumor Center, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Department of Radiology, Weill Medical College of Cornell University, New York, NY 10065, USA; Department of Neuroscience, Weill-Cornell Graduate School of the Medical Sciences, New York, NY 10065, USA
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Natalizi F, Piras F, Vecchio D, Spalletta G, Piras F. Preoperative Navigated Transcranial Magnetic Stimulation: New Insight for Brain Tumor-Related Language Mapping. J Pers Med 2022; 12:1589. [PMID: 36294728 PMCID: PMC9604795 DOI: 10.3390/jpm12101589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 08/30/2023] Open
Abstract
Preoperative brain mapping methods are particularly important in modern neuro-oncology when a tumor affects eloquent language areas since damage to parts of the language circuits can cause significant impairments in daily life. This narrative review examines the literature regarding preoperative and intraoperative language mapping using repetitive navigated transcranial magnetic stimulation (rnTMS) with or without direct electrical stimulation (DES) in adult patients with tumors in eloquent language areas. The literature shows that rnTMS is accurate in detecting preexisting language disorders and positive intraoperative mapping regions. In terms of the region extent and clinical outcomes, rnTMS has been shown to be accurate in identifying positive sites to guide resection, reducing surgery duration and craniotomy size and thus improving clinical outcomes. Before incorporating rnTMS into the neurosurgical workflow, the refinement of protocols and a consensus within the neuro-oncology community are required.
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Affiliation(s)
- Federica Natalizi
- Laboratory of Neurophychiatry, IRCSS Santa Lucia Fundation, Via Ardeatina 306, 00134 Rome, Italy
- Department of Psychology, “Sapienza” University of Rome, Via dei Marsi 78, 00185 Rome, Italy
- PhD Program in Behavioral Neuroscience, Sapienza University of Rome, 00161 Rome, Italy
| | - Federica Piras
- Laboratory of Neurophychiatry, IRCSS Santa Lucia Fundation, Via Ardeatina 306, 00134 Rome, Italy
| | - Daniela Vecchio
- Laboratory of Neurophychiatry, IRCSS Santa Lucia Fundation, Via Ardeatina 306, 00134 Rome, Italy
| | - Gianfranco Spalletta
- Laboratory of Neurophychiatry, IRCSS Santa Lucia Fundation, Via Ardeatina 306, 00134 Rome, Italy
| | - Fabrizio Piras
- Laboratory of Neurophychiatry, IRCSS Santa Lucia Fundation, Via Ardeatina 306, 00134 Rome, Italy
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21
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Ge H, Yan Z, Liu D, Qi W, Chen S, Yang K, Liu H, Zou Y, Hu X, Liu Y, Chen J. Synergetic reorganization of the contralateral structure and function in patients with unilateral frontal glioma. Front Neurosci 2022; 16:1016693. [PMID: 36213734 PMCID: PMC9538327 DOI: 10.3389/fnins.2022.1016693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022] Open
Abstract
Objective This study aimed to investigate the contralateral structural and functional plasticity induced by frontal gliomas. Methods Patients with left (n = 49) or right (n = 52) frontal diffuse glioma were enrolled along with 35 age- matched healthy controls (HCs). The gray-matter volumes (GMVs) of the contralesional region were measured using the voxel-based morphometry (VBM) analysis. Additionally, the amplitude of low-frequency fluctuation (ALFF) of the contralesional region was calculated via resting state functional magnetic resonance imaging (MRI) to assess functional alterations. Result The GMV of the contralateral orbitofrontal cortex of the right or left frontal gliomas was significantly larger than the corresponding GMV in the controls. In the patients with right frontal glioma, the GMV and ALFF in the left inferior frontal gyrus were significantly increased compared with those in the controls. Conclusion Glioma invasion of the frontal lobe can induce contralateral structural compensation and functional compensation, which show synergy in the left inferior frontal gyrus. Our findings explain why patients with unilateral frontal glioma can have functional balance, and offer the possibility of preserving the brain function while maximizing tumor removal.
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Affiliation(s)
- Honglin Ge
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zheng Yan
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Dongming Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenzhang Qi
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Shanshan Chen
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Kun Yang
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Hongyi Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yuanjie Zou
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xinhua Hu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yong Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Yong Liu,
| | - Jiu Chen
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
- Jiu Chen,
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22
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Contralesional Cortical and Network Features Associated with Preoperative Language Deficit in Glioma Patients. Cancers (Basel) 2022; 14:cancers14184469. [PMID: 36139629 PMCID: PMC9496725 DOI: 10.3390/cancers14184469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Gliomas that infiltrate eloquent areas can damage the corresponding cortical or subcortical structures, leading to language dysfunction. A total of 20–40% of eloquent area glioma patients have language deficits. Gliomas anchored in eloquent areas cause varying degrees of language impairment. A tumor’s size, grade, location, and contralesional compensation may explain these differences. This study aimed to retrospectively explore gray and white matter plasticity in the contralesional hemisphere of patients with gliomas in the eloquent area using VBM and DTI network analysis. Abstract Lower-grade Gliomas anchored in eloquent areas cause varying degrees of language impairment. Except for a tumor’s features, contralesional compensation may explain these differences. Therefore, studying changes in the contralateral hemisphere can provide insights into the underlying mechanisms of language function compensation in patients with gliomas. This study included 60 patients with eloquent-area or near-eloquent-area gliomas. The participants were grouped according to the degree of language defect. T1 and diffusion tensor imaging were obtained. The contralesional cortical volume and the subcortical network were compared between groups. Patients with unimpaired language function showed elevated cortical volume in the midline areas of the frontal and temporal lobes. In subcortical networks, the group also had the highest global efficiency and shortest global path length. Ten nodes had intergroup differences in nodal efficiency, among which four nodes were in the motor area and four nodes were in the language area. Linear correlation was observed between the efficiency of the two nodes and the patient’s language function score. Functional compensation in the contralesional hemisphere may alleviate language deficits in patients with gliomas. Structural compensation mainly occurs in the contralesional midline area in the frontal and temporal lobes, and manifests as an increase in cortical volume and subcortical network efficiency.
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Duffau H. Repeated Awake Surgical Resection(s) for Recurrent Diffuse Low-Grade Gliomas: Why, When, and How to Reoperate? Front Oncol 2022; 12:947933. [PMID: 35865482 PMCID: PMC9294369 DOI: 10.3389/fonc.2022.947933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Early maximal surgical resection is the first treatment in diffuse low-grade glioma (DLGG), because the reduction of tumor volume delays malignant transformation and extends survival. Awake surgery with intraoperative mapping and behavioral monitoring enables to preserve quality of life (QoL). However, because of the infiltrative nature of DLGG, relapse is unavoidable, even after (supra)total resection. Therefore, besides chemotherapy and radiotherapy, the question of reoperation(s) is increasingly raised, especially because patients with DLGG usually enjoy a normal life with long-lasting projects. Here, the purpose is to review the literature in the emerging field of iterative surgeries in DLGG. First, long-term follow-up results showed that patients with DLGG who underwent multiple surgeries had an increased survival (above 17 years) with preservation of QoL. Second, the criteria guiding the decision to reoperate and defining the optimal timing are discussed, mainly based on the dynamic intercommunication between the glioma relapse (including its kinetics and pattern of regrowth) and the reactional cerebral reorganization—i.e., mechanisms underpinning reconfiguration within and across neural networks to enable functional compensation. Third, how to adapt medico-surgical strategy to this individual spatiotemporal brain tumor interplay is detailed, by considering the perpetual changes in connectome. These data support early reoperation in recurrent DLGG, before the onset of symptoms and before malignant transformation. Repeat awake resection(s) should be integrated in a global management including (neo)adjuvant medical treatments, to enhance long-lasting functional and oncological outcomes. The prediction of potential and limitation of neuroplasticity at each step of the disease must be improved to anticipate personalized multistage therapeutic attitudes.
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Affiliation(s)
- Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- Team “Plasticity of Central Nervous System, Stem Cells and Glial Tumors”, National Institute for Health and Medical Research (INSERM), U1191 Laboratory, Institute of Functional Genomics, University of Montpellier, Montpellier, France
- *Correspondence: Hugues Duffau,
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24
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Di G, Tan M, Xu R, Zhou W, Duan K, Hu Z, Cao X, Zhang H, Jiang X. Altered Structural and Functional Patterns Within Executive Control Network Distinguish Frontal Glioma-Related Epilepsy. Front Neurosci 2022; 16:916771. [PMID: 35692418 PMCID: PMC9179179 DOI: 10.3389/fnins.2022.916771] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/05/2022] [Indexed: 11/27/2022] Open
Abstract
Background The tumor invasion of the frontal lobe induces changes in the executive control network (ECN). It remains unclear whether epileptic seizures in frontal glioma patients exacerbate the structural and functional alterations within the ECN, and whether these changes can be used to identify glioma-related seizures at an early stage. This study aimed to investigate the altered structural and functional patterns of ECN in frontal gliomas without epilepsy (non-FGep) and frontal gliomas with epilepsy (FGep) and to evaluate whether the patterns can accurately distinguish glioma-related epilepsy. Methods We measured gray matter (GM) volume, regional homogeneity (ReHo), and functional connectivity (FC) within the ECN to identify the structural and functional changes in 50 patients with frontal gliomas (29 non-FGep and 21 FGep) and 39 healthy controls (CN). We assessed the relationships between the structural and functional changes and cognitive function using partial correlation analysis. Finally, we applied a pattern classification approach to test whether structural and functional abnormalities within the ECN can distinguish non-FGep and FGep from CN subjects. Results Within the ECN, non-FGep and FGep showed increased local structure (GM) and function (ReHo), and decreased FC between brain regions compared to CN. Also, non-FGep and FGep showed differential patterns of structural and functional abnormalities within the ECN, and these abnormalities are more severe in FGep than in non-FGep. Lastly, FC between the right superior frontal gyrus and right dorsolateral prefrontal cortex was positively correlated with episodic memory scores in non-FGep and FGep. In particular, the support vector machine (SVM) classifier based on structural and functional abnormalities within ECN could accurately distinguish non-FGep and FGep from CN, and FGep from non-FGep on an individual basis with very high accuracy, area under the curve (AUC), sensitivity, and specificity. Conclusion Tumor invasion of the frontal lobe induces local structural and functional reorganization within the ECN, exacerbated by the accompanying epileptic seizures. The ECN abnormalities can accurately distinguish the presence or absence of epileptic seizures in frontal glioma patients. These findings suggest that differential ECN patterns can assist in the early identification and intervention of epileptic seizures in frontal glioma patients.
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Affiliation(s)
- Guangfu Di
- Department of Neurosurgery, The Translational Research Institute for Neurological Disorders of Wannan Medical College, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Mingze Tan
- Department of Neurosurgery, The Translational Research Institute for Neurological Disorders of Wannan Medical College, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Rui Xu
- Department of Radiology, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Wei Zhou
- Department of Neurosurgery, The Translational Research Institute for Neurological Disorders of Wannan Medical College, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Kaiqiang Duan
- Department of Neurosurgery, The Translational Research Institute for Neurological Disorders of Wannan Medical College, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Zongwen Hu
- Department of Neurosurgery, The Translational Research Institute for Neurological Disorders of Wannan Medical College, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Xiaoxiang Cao
- Department of Neurosurgery, The Translational Research Institute for Neurological Disorders of Wannan Medical College, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Hongchuang Zhang
- Department of Radiology, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Xiaochun Jiang
- Department of Neurosurgery, The Translational Research Institute for Neurological Disorders of Wannan Medical College, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China
- *Correspondence: Xiaochun Jiang,
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Lv K, Cao X, Wang R, Du P, Fu J, Geng D, Zhang J. Neuroplasticity of Glioma Patients: Brain Structure and Topological Network. Front Neurol 2022; 13:871613. [PMID: 35645982 PMCID: PMC9136300 DOI: 10.3389/fneur.2022.871613] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/26/2022] [Indexed: 11/19/2022] Open
Abstract
Glioma is the most common primary malignant brain tumor in adults. It accounts for about 75% of such tumors and occurs more commonly in men. The incidence rate has been increasing in the past 30 years. Moreover, the 5-year overall survival rate of glioma patients is < 35%. Different locations, grades, and molecular characteristics of gliomas can lead to different behavioral deficits and prognosis, which are closely related to patients' quality of life and associated with neuroplasticity. Some advanced magnetic resonance imaging (MRI) technologies can explore the neuroplasticity of structural, topological, biochemical metabolism, and related mechanisms, which may contribute to the improvement of prognosis and function in glioma patients. In this review, we summarized the studies conducted on structural and topological plasticity of glioma patients through different MRI technologies and discussed future research directions. Previous studies have found that glioma itself and related functional impairments can lead to structural and topological plasticity using multimodal MRI. However, neuroplasticity caused by highly heterogeneous gliomas is not fully understood, and should be further explored through multimodal MRI. In addition, the individualized prediction of functional prognosis of glioma patients from the functional level based on machine learning (ML) is promising. These approaches and the introduction of ML can further shed light on the neuroplasticity and related mechanism of the brain, which will be helpful for management of glioma patients.
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Affiliation(s)
- Kun Lv
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xin Cao
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
- Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China
- Institute of Intelligent Imaging Phenomics, International Human Phenome Institutes (Shanghai), Shanghai, China
| | - Rong Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
- Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China
- Institute of Intelligent Imaging Phenomics, International Human Phenome Institutes (Shanghai), Shanghai, China
| | - Peng Du
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Junyan Fu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Daoying Geng
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
- Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China
- Institute of Intelligent Imaging Phenomics, International Human Phenome Institutes (Shanghai), Shanghai, China
- *Correspondence: Daoying Geng
| | - Jun Zhang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
- Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China
- Institute of Intelligent Imaging Phenomics, International Human Phenome Institutes (Shanghai), Shanghai, China
- Jun Zhang
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Probing individual-level structural atrophy in frontal glioma patients. Neurosurg Rev 2022; 45:2845-2855. [PMID: 35508819 DOI: 10.1007/s10143-022-01800-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/15/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
Although every glioma patient varies in tumor size, location, histological grade and molecular biomarkers, non-tumoral morphological abnormalities are commonly detected by a statistical comparison among patient groups, missing the information of individual morphological alterations. In this study, we introduced an individual-level structural abnormality detection method for glioma patients and proposed several abnormality indexes to depict individual atrophy patterns. Forty-five patients with a glioma in the frontal lobe and fifty-one age-matched healthy controls participated in the study. Individual structural abnormality maps (SAM) were generated using patients' preoperative T1 images, by calculating the degree of deviation of voxel volume in each patient with the normative model built from healthy controls. Based on SAM, a series of individual abnormality indexes were computed, and their relationship with glioma characteristics was explored. The results demonstrated that glioma patients showed unique non-tumoral atrophy patterns with overlapping atrophy regions mainly located at hippocampus, parahippocampus, amygdala, insula, middle temporal gyrus and inferior temporal gyrus, which are closely related to the human cognitive functions. The abnormality indexes were associated with several molecular biomarkers including isocitrate dehydrogenase (IDH) mutation, 1p/19q co-deletion and telomerase reverse transcriptase (TERT) promoter mutation. Our study provides an effective way to access the individual-level non-tumoral structural abnormalities in glioma patients, which has the potential to significantly improve individualized precision medicine.
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27
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Fang S, Li L, Weng S, Guo Y, Zhong Z, Fan X, Jiang T, Wang Y. Contralesional Sensorimotor Network Participates in Motor Functional Compensation in Glioma Patients. Front Oncol 2022; 12:882313. [PMID: 35530325 PMCID: PMC9072743 DOI: 10.3389/fonc.2022.882313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Some gliomas in sensorimotor areas induce motor deficits, while some do not. Cortical destruction and reorganization contribute to this phenomenon, but detailed reasons remain unclear. This study investigated the differences of the functional connectivity and topological properties in the contralesional sensorimotor network (cSMN) between patients with motor deficit and those with normal motor function. Methods We retrospectively reviewed 65 patients (32 men) between 2017 and 2020. The patients were divided into four groups based on tumor laterality and preoperative motor status (deficit or non-deficit). Thirty-three healthy controls (18 men) were enrolled after matching for sex, age, and educational status. Graph theoretical measurement was applied to reveal alterations of the topological properties of the cSMN by analyzing resting-state functional MRI. Results The results for patients with different hemispheric gliomas were similar. The clustering coefficient, local efficiency, transitivity, and vulnerability of the cSMN significantly increased in the non-deficit group and decreased in the deficit group compared to the healthy group (p < 0.05). Moreover, the nodes of the motor-related thalamus showed a significantly increased nodal efficiency and nodal local efficiency in the non-deficit group and decreased in the deficit group compared with the healthy group (p < 0.05). Conclusions We posited the existence of two stages of alterations of the preoperative motor status. In the compensatory stage, the cSMN sacrificed stability to acquire high efficiency and to compensate for impaired motor function. With the glioma growing and the motor function being totally damaged, the cSMN returned to a stable state and maintained healthy hemispheric motor function, but with low efficiency.
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Affiliation(s)
- Shengyu Fang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Lianwang Li
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Shimeng Weng
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Yuhao Guo
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Zhang Zhong
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xing Fan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tao Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Research Unit of Accurate Diagnosis, Treatment and Translational Medicine of Brain Tumors, Chinese Academy of Medical Sciences, Beijing, China
| | - Yinyan Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
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Elin K, Malyutina S, Bronov O, Stupina E, Marinets A, Zhuravleva A, Dragoy O. A New Functional Magnetic Resonance Imaging Localizer for Preoperative Language Mapping Using a Sentence Completion Task: Validity, Choice of Baseline Condition, and Test–Retest Reliability. Front Hum Neurosci 2022; 16:791577. [PMID: 35431846 PMCID: PMC9006995 DOI: 10.3389/fnhum.2022.791577] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/04/2022] [Indexed: 11/24/2022] Open
Abstract
To avoid post-neurosurgical language deficits, intraoperative mapping of the language function in the brain can be complemented with preoperative mapping with functional magnetic resonance imaging (fMRI). The validity of an fMRI “language localizer” paradigm crucially depends on the choice of an optimal language task and baseline condition. This study presents a new fMRI “language localizer” in Russian using overt sentence completion, a task that comprehensively engages the language function by involving both production and comprehension at the word and sentence level. The paradigm was validated in 18 neurologically healthy volunteers who participated in two scanning sessions, for estimating test–retest reliability. For the first time, two baseline conditions for the sentence completion task were compared. At the group level, the paradigm significantly activated both anterior and posterior language-related regions. Individual-level analysis showed that activation was elicited most consistently in the inferior frontal regions, followed by posterior temporal regions and the angular gyrus. Test–retest reliability of activation location, as measured by Dice coefficients, was moderate and thus comparable to previous studies. Test–retest reliability was higher in the frontal than temporo-parietal region and with the most liberal statistical thresholding compared to two more conservative thresholding methods. Lateralization indices were expectedly left-hemispheric, with greater lateralization in the frontal than temporo-parietal region, and showed moderate test-retest reliability. Finally, the pseudoword baseline elicited more extensive and more reliable activation, although the syllable baseline appears more feasible for future clinical use. Overall, the study demonstrated the validity and reliability of the sentence completion task for mapping the language function in the brain. The paradigm needs further validation in a clinical sample of neurosurgical patients. Additionally, the study contributes to general evidence on test–retest reliability of fMRI.
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Affiliation(s)
- Kirill Elin
- Center for Language and Brain, HSE University, Moscow, Russia
| | - Svetlana Malyutina
- Center for Language and Brain, HSE University, Moscow, Russia
- *Correspondence: Svetlana Malyutina,
| | - Oleg Bronov
- Department of Radiology, National Medical and Surgical Center Named After N.I. Pirogov, Moscow, Russia
| | | | - Aleksei Marinets
- Department of Radiology, National Medical and Surgical Center Named After N.I. Pirogov, Moscow, Russia
| | - Anna Zhuravleva
- Center for Language and Brain, HSE University, Moscow, Russia
| | - Olga Dragoy
- Center for Language and Brain, HSE University, Moscow, Russia
- Institute of Linguistics, Russian Academy of Sciences, Moscow, Russia
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Hu G, Ge H, Yang K, Liu D, Liu Y, Jiang Z, Hu X, Xiao C, Zou Y, Liu H, Hu X, Chen J. Altered static and dynamic voxel-mirrored homotopic connectivity in patients with frontal glioma. Neuroscience 2022; 490:79-88. [PMID: 35278629 DOI: 10.1016/j.neuroscience.2022.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/19/2022] [Accepted: 03/04/2022] [Indexed: 01/02/2023]
Abstract
Contralateral regions play critical role in functional compensation in glioma patients. Voxel-mirrored homotopic connectivity (VMHC) characterizes the intrinsic functional connectivity (FC) of the brain, considered to have a regional functional basis. We aimed to investigate the alterations of brain regional function and VMHC in patients with frontal glioma, and further investigated the correlation between these alterations and cognition. We enrolled patients with frontal glioma and matched healthy controls (HC). We chose degree centrality (DC), regional homogeneity (ReHo), and VMHC to investigate the alterations of regional function and intrinsic FC in patients. Furthermore, partial correlation analyses were conducted to explore the relationship between imaging functional indicators and cognitions. Compared with HC, patients showed decreased static VMHC within right and left middle frontal gyrus (MFG.R, MFG.L), left superior frontal gyrus (SFG.L), right precuneus (PCUN.R), and left precuneus (PCUN.L), decreased static DC within left cingulate gyrus (CG.L), right superior frontal gyrus (SFG.R), and right postcentral gyrus (POCG.R), decreased static ReHo within CG.L, decreased dynamic ReHo within right inferior parietal lobule (IPL.R), but increased dynamic VMHC (dVMHC) within PCUN.R and PCUN.L. Furthermore, values of decreased VMHC within MFG.R, decreased DC within CG.L, decreased ReHo within CG.L, and increased dVMHC within PCUN.R were significantly positively correlated with cognitive functions. We preliminarily confirmed glioma causes regional dysfunction and disturbs long-distance FC, and long-distance FC showed strong instability in patients with frontal glioma. Meanwhile, the correlation analyses indicated directions for cognitive protection in patients with frontal glioma.
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Affiliation(s)
- Guanjie Hu
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Honglin Ge
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Kun Yang
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Dongming Liu
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Yong Liu
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Zijuan Jiang
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Xiao Hu
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Chaoyong Xiao
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Yuanjie Zou
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Hongyi Liu
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China; Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Xinhua Hu
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China; Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
| | - Jiu Chen
- Institute of Neuropsychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, Jiangsu, 210029, China; Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
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30
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Pasquini L, Di Napoli A, Rossi-Espagnet MC, Visconti E, Napolitano A, Romano A, Bozzao A, Peck KK, Holodny AI. Understanding Language Reorganization With Neuroimaging: How Language Adapts to Different Focal Lesions and Insights Into Clinical Applications. Front Hum Neurosci 2022; 16:747215. [PMID: 35250510 PMCID: PMC8895248 DOI: 10.3389/fnhum.2022.747215] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/18/2022] [Indexed: 12/13/2022] Open
Abstract
When the language-dominant hemisphere is damaged by a focal lesion, the brain may reorganize the language network through functional and structural changes known as adaptive plasticity. Adaptive plasticity is documented for triggers including ischemic, tumoral, and epileptic focal lesions, with effects in clinical practice. Many questions remain regarding language plasticity. Different lesions may induce different patterns of reorganization depending on pathologic features, location in the brain, and timing of onset. Neuroimaging provides insights into language plasticity due to its non-invasiveness, ability to image the whole brain, and large-scale implementation. This review provides an overview of language plasticity on MRI with insights for patient care. First, we describe the structural and functional language network as depicted by neuroimaging. Second, we explore language reorganization triggered by stroke, brain tumors, and epileptic lesions and analyze applications in clinical diagnosis and treatment planning. By comparing different focal lesions, we investigate determinants of language plasticity including lesion location and timing of onset, longitudinal evolution of reorganization, and the relationship between structural and functional changes.
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Affiliation(s)
- Luca Pasquini
- Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, Rome, Italy
| | - Alberto Di Napoli
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, Rome, Italy
- Radiology Department, Castelli Hospital, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | | | - Emiliano Visconti
- Neuroradiology Unit, Cesena Surgery and Trauma Department, M. Bufalini Hospital, AUSL Romagna, Cesena, Italy
| | - Antonio Napolitano
- Medical Physics Department, Bambino Gesù Children’s Hospital, Rome, Italy
| | - Andrea Romano
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, Rome, Italy
| | - Alessandro Bozzao
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, Rome, Italy
| | - Kyung K. Peck
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Andrei I. Holodny
- Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, United States
- Department of Neuroscience, Weill-Cornell Graduate School of the Medical Sciences, New York, NY, United States
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31
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Untapped Neuroimaging Tools for Neuro-Oncology: Connectomics and Spatial Transcriptomics. Cancers (Basel) 2022; 14:cancers14030464. [PMID: 35158732 PMCID: PMC8833690 DOI: 10.3390/cancers14030464] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/13/2022] [Accepted: 01/15/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Brain imaging, specifically magnetic resonance imaging (MRI), plays a key role in the clinical and research aspects of neuro-oncology. Novel neuroimaging techniques enable the transformation of a brain MRI into a so-called average brain. This allows projects using already acquired brain MRIs to perform group analyses and draw conclusions. Once the data are in this average brain, several types of analyses can be performed. For example, determining the most vulnerable locations for certain tumor types or perhaps even the underlying circuitry and gene expression that might cause predisposition to tumor growth. This information may further our understanding of tumor behavior, leading to better patient counseling, surgery timing, and treatment monitoring. Abstract Neuro-oncology research is broad and includes several branches, one of which is neuroimaging. Magnetic resonance imaging (MRI) is instrumental for the diagnosis and treatment monitoring of patients with brain tumors. Most commonly, structural and perfusion MRI sequences are acquired to characterize tumors and understand their behaviors. Thanks to technological advances, structural brain MRI can now be transformed into a so-called average brain accounting for individual morphological differences, which enables retrospective group analysis. These normative analyses are uncommonly used in neuro-oncology research. Once the data have been normalized, voxel-wise analyses and spatial mapping can be performed. Additionally, investigations of underlying connectomics can be performed using functional and structural templates. Additionally, a recently available template of spatial transcriptomics has enabled the assessment of associated gene expression. The few published normative analyses have shown relationships between tumor characteristics and spatial localization, as well as insights into the circuitry associated with epileptogenic tumors and depression after cingulate tumor resection. The wide breadth of possibilities with normative analyses remain largely unexplored, specifically in terms of connectomics and imaging transcriptomics. We provide a framework for performing normative analyses in oncology while also highlighting their limitations. Normative analyses are an opportunity to address neuro-oncology questions from a different perspective.
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Lin Y, Liu J, Shi W. Interactive relationship between neuronal circuitry and glioma: A narrative review. GLIOMA 2022. [DOI: 10.4103/glioma.glioma_15_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Li Y, Wang P, Li B, Feng J, Qiu X. Gray matter structural plasticity in patients with basal ganglia germ cell tumors: A voxel-based morphometry study. Magn Reson Imaging 2021; 85:202-209. [PMID: 34687854 DOI: 10.1016/j.mri.2021.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/22/2021] [Accepted: 10/17/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Basal ganglia germ cell tumors (BGGCTs) are rare intracranial germ cell tumors (iGCTs) that often presents with cognitive impairment. OBJECTIVE To assess structural brain plasticity in the presence of unilateral basal ganglia germ cell tumors (BGGCTs), and the correlation between gray matter volume (GMV) changes and cognitive tests. MATERIALS AND METHODS We applied voxel-based morphometry (VBM) to structural magnetic resonance imaging (MRI) scans to compare a sample of 41 patients with BGGCTs in the left (n = 22) or right (n = 19) and a sample of 16 patients as control group using a two-sample t-test, correcting for family-wise-errors. A battery of cognitive tests was administered to all BGGCTs patients prior to MRI. We used Pearson correlation analysis to assess the correlation between cognitive test scores and GMV changes. RESULTS In patients with left BGGCTs, whole-brain VBM analysis revealed a large cluster of voxels reflecting an increase in GMV in the left parahippocampal region (k = 529 voxels, T = 4.18, p < 0.01), right middle cingulate cortex (k = 172 voxels, T = 3.96, p < 0.01), and a decrease in volume in the left thalamus (k = 527 voxels, T = -4.88, p < 0.01), right inferior frontal gyrus (k = 495 voxels, T = -4.29, p < 0.01). Pearson correlation analysis showed that the GMV were significantly correlated with the Integrated Visual and Auditory continuous performance test (IVA-CPT) scale (r = 0.637, P = 0.002), abstract reasoning (r = 0.597, P = 0.011), Self-rating Depression Scale (SAS) scale (r = -0.623, P = 0.004) and memory recall (r = 0.648, P = 0.003). CONCLUSION These results demonstrate that slow growing but destructive BGGCTs markedly and asymmetrically effect the GMV in left parahippocampal, left thalamus, right middle cingulate cortex, right inferior frontal gyrus and GMV changes were significantly associated with cognitive test.
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Affiliation(s)
- Yanong Li
- Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peng Wang
- Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Bo Li
- Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jin Feng
- Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoguang Qiu
- Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Molecular Neuropathology, Beijing Neurosurgery Institute, Capital Medical University, Beijing, China.
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34
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Duffau H. The death of localizationism: The concepts of functional connectome and neuroplasticity deciphered by awake mapping, and their implications for best care of brain-damaged patients. Rev Neurol (Paris) 2021; 177:1093-1103. [PMID: 34563375 DOI: 10.1016/j.neurol.2021.07.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/20/2021] [Accepted: 07/23/2021] [Indexed: 11/28/2022]
Abstract
Although clinical neurology was mainly erected on the dogma of localizationism, numerous reports have described functional recovery after lesions involving presumed non-compensable areas in an inflexible view of brain processing. Here, the purpose is to review new insights into the functional connectome and the mechanisms underpinning neural plasticity, gained from intraoperative direct electrostimulation mapping and real-time behavioral monitoring in awake patients, combined with perioperative neuropsychological and neuroimaging data. Such longitudinal anatomo-functional correlations resulted in the reappraisal of classical models of cognition, especially by highlighting the dynamic interplay within and between neural circuits, leading to the concept of meta-network (network of networks), as well as by emphasizing that subcortical connectivity is the main limitation of neuroplastic potential. Beyond their contribution to basic neurosciences, these findings might also be helpful for an optimization of care for brain-damaged patients, such as in resective oncological or epilepsy neurosurgery in structures traditionally deemed inoperable (e.g., in Broca's area) as well as for elaborating new programs of functional rehabilitation, eventually combined with transcranial brain stimulation, aiming to change the connectivity patterns in order to enhance cognitive competences following cerebral injury.
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Affiliation(s)
- H Duffau
- Department of Neurosurgery, Gui-de-Chauliac Hospital, Montpellier University Medical Center, 80, avenue Augustin-Fliche, 34295 Montpellier, France; National Institute for Health and Medical Research (INSERM), U1191 Laboratory, Team "Brain Plasticity, Stem Cells and Low-Grade Gliomas", Institute of Functional Genomics, University of Montpellier, 34091 Montpellier, France.
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35
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Jütten K, Weninger L, Mainz V, Gauggel S, Binkofski F, Wiesmann M, Merhof D, Clusmann H, Na CH. Dissociation of structural and functional connectomic coherence in glioma patients. Sci Rep 2021; 11:16790. [PMID: 34408195 PMCID: PMC8373888 DOI: 10.1038/s41598-021-95932-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/31/2021] [Indexed: 01/21/2023] Open
Abstract
With diffuse infiltrative glioma being increasingly recognized as a systemic brain disorder, the macroscopically apparent tumor lesion is suggested to impact on cerebral functional and structural integrity beyond the apparent lesion site. We investigated resting-state functional connectivity (FC) and diffusion-MRI-based structural connectivity (SC) (comprising edge-weight (EW) and fractional anisotropy (FA)) in isodehydrogenase mutated (IDHmut) and wildtype (IDHwt) patients and healthy controls. SC and FC were determined for whole-brain and the Default-Mode Network (DMN), mean intra- and interhemispheric SC and FC were compared across groups, and partial correlations were analyzed intra- and intermodally. With interhemispheric EW being reduced in both patient groups, IDHwt patients showed FA decreases in the ipsi- and contralesional hemisphere, whereas IDHmut patients revealed FA increases in the contralesional hemisphere. Healthy controls showed strong intramodal connectivity, each within the structural and functional connectome. Patients however showed a loss in structural and reductions in functional connectomic coherence, which appeared to be more pronounced in IDHwt glioma patients. Findings suggest a relative dissociation of structural and functional connectomic coherence in glioma patients at the time of diagnosis, with more structural connectomic aberrations being encountered in IDHwt glioma patients. Connectomic profiling may aid in phenotyping and monitoring prognostically differing tumor types.
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Affiliation(s)
- Kerstin Jütten
- Department of Neurosurgery, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Leon Weninger
- Imaging and Computer Vision, RWTH Aachen University, Templergraben 55, 52074, Aachen, Germany
| | - Verena Mainz
- Institute of Medical Psychology and Medical Sociology, RWTH Aachen University, Pauwelsstraße 19, 52074, Aachen, Germany
| | - Siegfried Gauggel
- Institute of Medical Psychology and Medical Sociology, RWTH Aachen University, Pauwelsstraße 19, 52074, Aachen, Germany
| | - Ferdinand Binkofski
- Division of Clinical Cognitive Sciences, RWTH Aachen University, Pauwelsstraße 17, 52074, Aachen, Germany
| | - Martin Wiesmann
- Department of Diagnostic and Interventional Neuroradiology, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Dorit Merhof
- Imaging and Computer Vision, RWTH Aachen University, Templergraben 55, 52074, Aachen, Germany
| | - Hans Clusmann
- Department of Neurosurgery, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany
| | - Chuh-Hyoun Na
- Department of Neurosurgery, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany
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Kinno R, Muragaki Y, Maruyama T, Tamura M, Tanaka K, Ono K, Sakai KL. Differential Effects of a Left Frontal Glioma on the Cortical Thickness and Complexity of Both Hemispheres. Cereb Cortex Commun 2021; 1:tgaa027. [PMID: 34296101 PMCID: PMC8152868 DOI: 10.1093/texcom/tgaa027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/20/2020] [Accepted: 06/21/2020] [Indexed: 12/13/2022] Open
Abstract
Glioma is a type of brain tumor that infiltrates and compresses the brain as it grows. Focal gliomas affect functional connectivity both in the local region of the lesion and the global network of the brain. Any anatomical changes associated with a glioma should thus be clarified. We examined the cortical structures of 15 patients with a glioma in the left lateral frontal cortex and compared them with those of 15 healthy controls by surface-based morphometry. Two regional parameters were measured with 3D-MRI: the cortical thickness (CT) and cortical fractal dimension (FD). The FD serves as an index of the topological complexity of a local cortical surface. Our comparative analyses of these parameters revealed that the left frontal gliomas had global effects on the cortical structures of both hemispheres. The structural changes in the right hemisphere were mainly characterized by a decrease in CT and mild concomitant decrease in FD, whereas those in the peripheral regions of the glioma (left hemisphere) were mainly characterized by a decrease in FD with relative preservation of CT. These differences were found irrespective of tumor volume, location, or grade. These results elucidate the structural effects of gliomas, which extend to the distant contralateral regions.
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Affiliation(s)
- Ryuta Kinno
- Department of Basic Science, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, 153-8902, Japan
| | - Yoshihiro Muragaki
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, 162-8666, Japan
| | - Takashi Maruyama
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, 162-8666, Japan
| | - Manabu Tamura
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, 162-8666, Japan
| | - Kyohei Tanaka
- Department of Basic Science, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, 153-8902, Japan
| | - Kenjiro Ono
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, 142-8666, Japan
| | - Kuniyoshi L Sakai
- Department of Basic Science, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, 153-8902, Japan
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Quiñones I, Amoruso L, Pomposo Gastelu IC, Gil-Robles S, Carreiras M. What Can Glioma Patients Teach Us about Language (Re)Organization in the Bilingual Brain: Evidence from fMRI and MEG. Cancers (Basel) 2021; 13:2593. [PMID: 34070619 PMCID: PMC8198785 DOI: 10.3390/cancers13112593] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/20/2021] [Accepted: 05/20/2021] [Indexed: 12/15/2022] Open
Abstract
Recent evidence suggests that the presence of brain tumors (e.g., low-grade gliomas) triggers language reorganization. Neuroplasticity mechanisms called into play can transfer linguistic functions from damaged to healthy areas unaffected by the tumor. This phenomenon has been reported in monolingual patients, but much less is known about the neuroplasticity of language in the bilingual brain. A central question is whether processing a first or second language involves the same or different cortical territories and whether damage results in diverse recovery patterns depending on the language involved. This question becomes critical for preserving language areas in bilingual brain-tumor patients to prevent involuntary pathological symptoms following resection. While most studies have focused on intraoperative mapping, here, we go further, reporting clinical cases for five bilingual patients tested before and after tumor resection, using a novel multimethod approach merging neuroimaging information from fMRI and MEG to map the longitudinal reshaping of the language system. Here, we present four main findings. First, all patients preserved linguistic function in both languages after surgery, suggesting that the surgical intervention with intraoperative language mapping was successful in preserving cortical and subcortical structures necessary for brain plasticity at the functional level. Second, we found reorganization of the language network after tumor resection in both languages, mainly reflected by a shift of activity to right hemisphere nodes and the recruitment of ipsilesional left nodes. Third, we found that this reorganization varied according to the language involved, indicating that L1 and L2 follow different reshaping patterns after surgery. Fourth, oscillatory longitudinal effects were correlated with BOLD laterality changes in superior parietal and middle frontal areas. These findings may reflect that neuroplasticity impacts on the compensatory involvement of executive control regions, supporting the allocation of cognitive resources as a consequence of increased attentional demands. Furthermore, these results hint at the complementary role of this neuroimaging approach in language mapping, with fMRI offering excellent spatial localization and MEG providing optimal spectrotemporal resolution.
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Affiliation(s)
- Ileana Quiñones
- Neurobiology of Language Group, Basque Center on Cognition, Brain and Language (BCBL), 20009 Donostia-San Sebastián, Spain; (L.A.); (M.C.)
| | - Lucia Amoruso
- Neurobiology of Language Group, Basque Center on Cognition, Brain and Language (BCBL), 20009 Donostia-San Sebastián, Spain; (L.A.); (M.C.)
- IKERBASQUE, Basque Foundation for Science, 48009 Bilbao, Spain
| | | | - Santiago Gil-Robles
- BioCruces Research Institute, 48015 Bilbao, Spain;
- Department of Neurosurgery, Hospital Quironsalud, 28223 Madrid, Spain
| | - Manuel Carreiras
- Neurobiology of Language Group, Basque Center on Cognition, Brain and Language (BCBL), 20009 Donostia-San Sebastián, Spain; (L.A.); (M.C.)
- IKERBASQUE, Basque Foundation for Science, 48009 Bilbao, Spain
- Department of Basque Language and Communication, University of the Basque Country, UPV/EHU, 48940 Bilbao, Spain
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38
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Huang Z, Li G, Li Z, Sun S, Zhang Y, Hou Z, Xie J. Contralesional Structural Plasticity in Different Molecular Pathologic Subtypes of Insular Glioma. Front Neurol 2021; 12:636573. [PMID: 33935941 PMCID: PMC8079625 DOI: 10.3389/fneur.2021.636573] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/08/2021] [Indexed: 12/25/2022] Open
Abstract
Neuroplasticity may preserve neurologic function in insular glioma, thereby improving prognosis following resection. However, the anatomic and molecular bases of this phenomenon are not known. To address this gap in knowledge, the present study investigated contralesional compensation in different molecular pathologic subtypes of insular glioma by high-resolution three-dimensional T1-weighted structural magnetic resonance imaging. A total of 52 patients with insular glioma were examined. We compared the gray matter volume (GMV) of the contralesional insula according to histological grade [low-grade glioma (LGG) and high-grade glioma (HGG)] and molecular pathology status [isocitrate dehydrogenase (IDH) mutation, telomerase reverse-transcriptase (TERT) promoter mutation, and 1p19q codeletion] by voxel-based morphometry (VBM). A cluster of 320 voxels in contralesional insula with higher GMV was observed in glioma with IDH mutation as compared to IDH wild-type tumors by region of interest-based VBM analysis (family-wise error-corrected at p < 0.05). The GMV of the entire contralesional insula was also larger in insular glioma patients with IDH mutation than in patients with wild-type IDH. However, there was no association between histological grade, TERT promoter mutation, or 1p19q codeletion and GMV in the contralesional insula. Thus, IDH mutation is associated with greater structural compensation in insular glioma. These findings may be useful for predicting neurocognitive and functional outcomes in patients undergoing resection surgery.
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Affiliation(s)
- Zhenxing Huang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Centre for Neurological Diseases, Beijing, China
| | - Gen Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Centre for Neurological Diseases, Beijing, China
| | - Zhenye Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Centre for Neurological Diseases, Beijing, China
| | - Shengjun Sun
- China National Clinical Research Centre for Neurological Diseases, Beijing, China.,Neuroimaging Center, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Yazhuo Zhang
- China National Clinical Research Centre for Neurological Diseases, Beijing, China.,Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Zonggang Hou
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Centre for Neurological Diseases, Beijing, China
| | - Jian Xie
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Centre for Neurological Diseases, Beijing, China
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Brain connectomics applied to oncological neuroscience: from a traditional surgical strategy focusing on glioma topography to a meta-network approach. Acta Neurochir (Wien) 2021; 163:905-917. [PMID: 33564906 DOI: 10.1007/s00701-021-04752-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/01/2021] [Indexed: 02/07/2023]
Abstract
The classical way for surgical selection and planning in cerebral glioma mainly focused on tumor topography. The emerging science of connectomics, which aims of mapping brain connectivity, resulted in a paradigmatic shift from a modular account of cerebral organization to a meta-network perspective. Adaptive behavior is actually mediated by constant changes in interactions within and across large-scale delocalized neural systems underlying conation, cognition, and emotion. Here, to optimize the onco-functional balance of glioma surgery, the purpose is to switch toward a connectome-based resection taking account of both relationships between the tumor and critical distributed circuits (especially subcortical pathways) as well as the perpetual instability of the meta-network. Such dynamic in the neural spatiotemporal integration permits functional reallocation leading to neurological recovery after massive resection in structures traditionally thought as "inoperable." This better understanding of connectome increases benefit/risk ratio of surgery (i) by selecting resection in areas deemed "eloquent" according to a localizationist dogma; (ii), conversely, by refining intraoperative awake cognitive mapping and monitoring in so-called non-eloquent areas; (iii) by improving preoperative information, enabling an optimal selection of intrasurgical tasks tailored to the patient's wishes; (iv) by developing an "oncological disconnection surgery"; (v) by defining a personalized multistep surgical strategy adapted to individual brain reshaping potential; and (vi) ultimately by preserving environmentally and socially appropriate behavior, including return to work, while increasing the extent of (possibly repeated) resection(s). Such a holistic vision of neural processing can enhance reliability of connectomal surgery in oncological neuroscience and may also be applied to restorative neurosurgery.
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40
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Tatekawa H, Uetani H, Hagiwara A, Yao J, Oughourlian TC, Ueda I, Raymond C, Lai A, Cloughesy TF, Nghiemphu PL, Liau LM, Bahri S, Pope WB, Salamon N, Ellingson BM. Preferential tumor localization in relation to 18F-FDOPA uptake for lower-grade gliomas. J Neurooncol 2021; 152:573-582. [PMID: 33704629 DOI: 10.1007/s11060-021-03730-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/01/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Although tumor localization and 3,4-dihydroxy-6-18F-fluoro-L-phenylalanine (FDOPA) uptake may have an association, preferential tumor localization in relation to FDOPA uptake is yet to be investigated in lower-grade gliomas (LGGs). This study aimed to identify differences in the frequency of tumor localization between FDOPA hypometabolic and hypermetabolic LGGs using a probabilistic radiographic atlas. METHODS Fifty-one patients with newly diagnosed LGG (WHO grade II, 29; III, 22; isocitrate dehydrogenase wild-type, 21; mutant 1p19q non-codeleted,16; mutant codeleted, 14) who underwent FDOPA positron emission tomography (PET) were retrospectively selected. Semiautomated tumor segmentation on FLAIR was performed. Patients with LGGs were separated into two groups (FDOPA hypometabolic and hypermetabolic LGGs) according to the normalized maximum standardized uptake value of FDOPA PET (a threshold of the uptake in the striatum) within the segmented regions. Spatial normalization procedures to build a 3D MRI-based atlas using each segmented region were validated by an analysis of differential involvement statistical mapping. RESULTS Superimposition of regions of interest showed a high number of hypometabolic LGGs localized in the frontal lobe, while a high number of hypermetabolic LGGs was localized in the insula, putamen, and temporal lobe. The statistical mapping revealed that hypometabolic LGGs occurred more frequently in the superior frontal gyrus (close to the supplementary motor area), while hypermetabolic LGGs occurred more frequently in the insula. CONCLUSION Radiographic atlases revealed preferential frontal lobe localization for FDOPA hypometabolic LGGs, which may be associated with relatively early detection.
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Affiliation(s)
- Hiroyuki Tatekawa
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA.,Department of Radiological Science, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hiroyuki Uetani
- Department of Radiological Science, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Akifumi Hagiwara
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA.,Department of Radiological Science, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Jingwen Yao
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA.,Department of Radiological Science, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Bioengineering, Henry Samueli School of Engineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Talia C Oughourlian
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA.,Department of Radiological Science, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Neuroscience Interdepartmental Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Issei Ueda
- Department of Radiological Science, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Catalina Raymond
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA.,Department of Radiological Science, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Albert Lai
- UCLA Neuro-Oncology Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Timothy F Cloughesy
- UCLA Neuro-Oncology Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Phioanh L Nghiemphu
- UCLA Neuro-Oncology Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Linda M Liau
- UCLA Neuro-Oncology Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Shadfar Bahri
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Whitney B Pope
- Department of Radiological Science, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Noriko Salamon
- Department of Radiological Science, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Benjamin M Ellingson
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA. .,Department of Radiological Science, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA. .,Department of Bioengineering, Henry Samueli School of Engineering, University of California Los Angeles, Los Angeles, CA, USA. .,Neuroscience Interdepartmental Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA. .,UCLA Neuro-Oncology Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
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Zhang N, Yuan B, Yan J, Cheng J, Lu J, Wu J. Multivariate machine learning-based language mapping in glioma patients based on lesion topography. Brain Imaging Behav 2021; 15:2552-2562. [PMID: 33619646 DOI: 10.1007/s11682-021-00457-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 12/11/2020] [Accepted: 01/21/2021] [Indexed: 12/21/2022]
Abstract
Diffusive and progressive tumor infiltration within language-related areas of the brain induces functional reorganization. However, the macrostructural basis of subsequent language deficits is less clear. To address this issue, lesion topography data from 137 preoperative patients with left cerebral language-network gliomas (81 low-grade gliomas and 56 high-grade gliomas), were adopted for multivariate machine-learning-based lesion-language mapping analysis. We found that tumor location in the left posterior middle temporal gyrus-a bottleneck where both dorsal and ventral language pathways travel-predicted deficits of spontaneous speech (cluster size = 1356 mm3, false discovery rate corrected P < 0.05) and naming scores (cluster size = 1491 mm3, false discovery rate corrected P < 0.05) in the high-grade glioma group. In contrast, no significant lesion-language mapping results were observed in the low-grade glioma group, suggesting a large functional reorganization. These findings suggest that in patients with gliomas, the macrostructural plasticity mechanisms that modulate brain-behavior relationships depend on glioma grade.
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Affiliation(s)
- Nan Zhang
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui, Hefei, China.,Glioma Surgery Division, Neurologic Surgery Department, Huashan Hospital, Fudan University, Shanghai, China
| | - Binke Yuan
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China.,Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Guangzhou, China.,Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Jing Yan
- Department of MRI , The First Affiliated Hospital of Zhengzhou University , Zhengzhou, China
| | - Jingliang Cheng
- Department of MRI , The First Affiliated Hospital of Zhengzhou University , Zhengzhou, China
| | - Junfeng Lu
- Glioma Surgery Division, Neurologic Surgery Department, Huashan Hospital, Fudan University, Shanghai, China.
| | - Jinsong Wu
- Glioma Surgery Division, Neurologic Surgery Department, Huashan Hospital, Fudan University, Shanghai, China.,Institute of Brain-Intelligence Technology , Zhangjiang Lab, Shanghai, China
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Wang S, Sun H, Hu G, Xue C, Qi W, Rao J, Zhang F, Zhang X, Chen J. Altered Insular Subregional Connectivity Associated With Cognitions for Distinguishing the Spectrum of Pre-clinical Alzheimer's Disease. Front Aging Neurosci 2021; 13:597455. [PMID: 33643021 PMCID: PMC7902797 DOI: 10.3389/fnagi.2021.597455] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 01/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Subjective cognitive decline (SCD) and amnestic mild cognitive impairment (aMCI) are regarded as part of the pre-clinical Alzheimer's disease (AD) spectrum. The insular subregional networks are thought to have diverse intrinsic connectivity patterns that are involved in cognitive and emotional processing. We set out to investigate convergent and divergent altered connectivity patterns of the insular subregions across the spectrum of pre-clinical AD and evaluated how well these patterns can differentiate the pre-clinical AD spectrum. Method: Functional connectivity (FC) analyses in insular subnetworks were carried out among 38 patients with SCD, 56 patients with aMCI, and 55 normal controls (CNs). Logistic regression analyses were used to construct models for aMCI and CN, as well as SCD and CN classification. Finally, we conducted correlation analyses to measure the relationship between FCs of altered insular subnetworks and cognition. Results: Patients with SCD presented with reduced FC in the bilateral cerebellum posterior lobe and increased FC in the medial frontal gyrus and the middle temporal gyrus. On the other hand, patients with aMCI largely presented with decreased FC in the bilateral inferior parietal lobule, the cerebellum posterior lobe, and the anterior cingulate cortex, as well as increased FC in the medial and inferior frontal gyrus, and the middle and superior temporal gyrus. Logistic regression analyses indicated that a model composed of FCs among altered insular subnetworks in patients with SCD was able to appropriately classify 83.9% of patients with SCD and CN, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.876, 81.6% sensitivity, and 81.8% specificity. A model consisting of altered insular subnetwork FCs in patients with aMCI was able to appropriately classify 86.5% of the patients with aMCI and CNs, with an AUC of 0.887, 80.4% sensitivity, and 83.6% specificity. Furthermore, some of the FCs among altered insular subnetworks were significantly correlated with episodic memory and executive function. Conclusions: Patients with SCD and aMCI are likely to share similar convergent and divergent altered intrinsic FC patterns of insular subnetworks as the pre-clinical AD spectrum, and presented with abnormalities among subnetworks. Based on these abnormalities, individuals can be correctly differentiated in the pre-clinical AD spectrum. These results suggest that alterations in insular subnetworks can be utilized as a potential biomarker to aid in conducting a clinical diagnosis of the spectrum of pre-clinical AD.
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Affiliation(s)
- Siyu Wang
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, China.,Fourth Clinical College of Nanjing Medical University, Nanjing, China
| | - Haiting Sun
- Department of Pediatrics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Guanjie Hu
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Chen Xue
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenzhang Qi
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jiang Rao
- Department of Rehabilitation, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Fuquan Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiangrong Zhang
- Department of Pediatrics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.,Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jiu Chen
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, China.,Fourth Clinical College of Nanjing Medical University, Nanjing, China
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Dumić K, Krnić N, Jovanović I, Ruška B, Adamec I, Fanciulli A, Habek M. Insular damage causing transient baroreflex dysfunction in a teenager with Allgrove syndrome. Clin Auton Res 2021; 31:581-584. [PMID: 33560460 DOI: 10.1007/s10286-021-00779-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/23/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Katja Dumić
- Department of Pediatric Endocrinology and Diabetes, University Hospital Center Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Nevena Krnić
- Department of Pediatric Endocrinology and Diabetes, University Hospital Center Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivan Jovanović
- Department of Neuroradiology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Berislav Ruška
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia
| | - Ivan Adamec
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia
| | - Alessandra Fanciulli
- Autonomic Unit, Division of Neurobiology, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Mario Habek
- School of Medicine, University of Zagreb, Zagreb, Croatia. .,Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia.
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Liu D, Chen J, Hu X, Hu G, Liu Y, Yang K, Xiao C, Zou Y, Liu H. Contralesional homotopic functional plasticity in patients with temporal glioma. J Neurosurg 2021; 134:417-425. [PMID: 31923896 DOI: 10.3171/2019.11.jns191982] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/05/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to explore the contralesional homotopic functional plasticity in the brain of patients with unilateral temporal glioma. METHODS Demographic, neurocognitive, and resting-state functional MRI data were collected from 17 patients with temporal glioma (10 in the right lobe and 7 in the left lobe), along with 14 age- and sex-matched healthy controls. The amplitude of low-frequency fluctuation (ALFF) of the contralesional homotopic region and 2 control regions was examined. The region-of-interest-based analysis was used to determine the altered functional connectivity (FC) of the contralesional homotopic region, showing significantly different intrinsic regional brain activity between patients and controls. Partial correlation analysis was conducted to determine the association between the altered neural activity and behavioral characteristics. RESULTS Compared with controls, patients with right temporal glioma exhibited significantly increased ALFF in the contralesional homotopic hippocampus and parahippocampal region. In addition, the intrinsic regional activity in these regions was negatively correlated with the visuospatial score (r = -0.718, p = 0.045). Whole-brain FC analysis revealed significantly increased FC between the left hippocampus and parahippocampal regions and the left inferior temporal gyrus, and decreased FC between the left hippocampus and parahippocampal regions and the left inferior frontal gyrus. No significant changes were found in the 2 control regions. CONCLUSIONS Contralesional homotopic regions are instrumental in the process of neural plasticity and functional compensation observed in patients with unilateral temporal glioma. The observed findings might be used to help preoperative evaluation or rehabilitation of postsurgical patients.
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Affiliation(s)
- Dongming Liu
- 1Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu
| | - Jiu Chen
- 2Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, Jiangsu
- 3Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, Jiangsu; and
| | - Xinhua Hu
- 1Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu
- 3Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, Jiangsu; and
| | - Guanjie Hu
- 1Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu
| | - Yong Liu
- 1Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu
| | - Kun Yang
- 1Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu
| | - Chaoyong Xiao
- 3Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, Jiangsu; and
- 4Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuanjie Zou
- 1Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu
- 3Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, Jiangsu; and
| | - Hongyi Liu
- 1Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu
- 3Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, Jiangsu; and
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Almairac F, Deverdun J, Cochereau J, Coget A, Lemaitre AL, Moritz-Gasser S, Duffau H, Herbet G. Homotopic redistribution of functional connectivity in insula-centered diffuse low-grade glioma. Neuroimage Clin 2021; 29:102571. [PMID: 33508623 PMCID: PMC7840474 DOI: 10.1016/j.nicl.2021.102571] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE In the event of neural injury, the homologous contralateral brain areas may play a compensatory role to avoid or limit the functional loss. However, this dynamic strategy of functional redistribution is not clearly established, especially in the pathophysiological context of diffuse low-grade glioma. Our aim here was to assess the extent to which unilateral tumor infiltration of the insula dynamically modulates the functional connectivity of the contralesional one. METHODS Using resting-state functional connectivity MRI, a seed-to-ROI approach was employed in 52 insula-centered glioma patients (n = 30 left and 22 right) compared with 19 age-matched healthy controls. RESULTS Unsurprisingly, a significant decrease of the inter-insular connectivity was observed in both patient groups. More importantly, the analyses revealed a significant increase of the contralesional insular connectivity towards both cerebral hemispheres, especially in cortical areas forming the visual and the sensorimotor networks. This functional redistribution was not identified when the analyses were performed on three control regions for which the homologous area was not impaired by the tumor. This overall pattern of results indicates that massive infiltration of the insular cortex causes a significant redeployment of the contralesional functional connectivity. CONCLUSION This general finding suggests that the undamaged insula plays a role in the functional compensation usually observed in this patient population, and thus provides compelling support for the concept of homotopic functional plasticity in brain-damaged patients.
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Affiliation(s)
- Fabien Almairac
- Department of Neurosurgery, Pasteur 2 Hospital, Nice University Medical Center, Nice, France; Université Côte d'Azur, Nice, France
| | - Jeremy Deverdun
- I2FH, Institut d'Imagerie Fonctionnelle Humaine, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France; Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Jérôme Cochereau
- Department of Neurosurgery, La Miletrie Hospital, Poitiers University Medical Center, Poitiers, France; Institute of Functional Genomics, INSERM 1191, University of Montpellier, France; University of Montpellier, Montpellier, France
| | - Arthur Coget
- I2FH, Institut d'Imagerie Fonctionnelle Humaine, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France; Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Anne-Laure Lemaitre
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Sylvie Moritz-Gasser
- Institute of Functional Genomics, INSERM 1191, University of Montpellier, France; University of Montpellier, Montpellier, France; Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Hugues Duffau
- Institute of Functional Genomics, INSERM 1191, University of Montpellier, France; University of Montpellier, Montpellier, France; Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Guillaume Herbet
- Institute of Functional Genomics, INSERM 1191, University of Montpellier, France; University of Montpellier, Montpellier, France; Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.
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Fang S, Zhou C, Wang Y, Jiang T. Contralesional functional network reorganization of the insular cortex in diffuse low-grade glioma patients. Sci Rep 2021; 11:623. [PMID: 33436741 PMCID: PMC7804949 DOI: 10.1038/s41598-020-79845-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/14/2020] [Indexed: 12/15/2022] Open
Abstract
Diffuse low-grade gliomas (DLGGs) growing on the insular lobe induce contralesional hemispheric insular lobe compensation of damaged functioning by increasing cortical volumes. However, it remains unclear how functional networks are altered in patients with insular lobe DLGGs during functional compensation. Thirty-five patients with insular DLGGs were classified into the left (insL, n = 16) and right groups (insR, n = 19), and 33 healthy subjects were included in the control group. Resting state functional magnetic resonance imaging was used to generate functional connectivity (FC), and network topological properties were evaluated using graph theoretical analysis based on FC matrices. Network-based statistics were applied to compare differences in the FC matrices. A false discovery rate was applied to correct the topological properties. There was no difference in the FC of edges between the control and insL groups; however, the nodal shortest path length of the right insular lobe was significantly increased in the insL group compared to the control group. Additionally, FC was increased in the functional edges originating from the left insular lobe in the insR group compared to the control group. Moreover, there were no differences in topological properties between the insR and control groups. The contralesional insular lobe is crucial for network alterations. The detailed patterns of network alterations were different depending on the affected hemisphere. The observed network alterations might be associated with functional network reorganization and functional compensation.
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Affiliation(s)
- Shengyu Fang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 119, the Western Road of the southern 4th Ring Road, Beijing, 100070, China
| | - Chunyao Zhou
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 119, the Western Road of the southern 4th Ring Road, Beijing, 100070, China
| | - Yinyan Wang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. .,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 119, the Western Road of the southern 4th Ring Road, Beijing, 100070, China.
| | - Tao Jiang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. .,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 119, the Western Road of the southern 4th Ring Road, Beijing, 100070, China. .,Research Unit of Accurate Diagnosis, Treatment, and Translational Medicine of Brain Tumors Chinese (2019RU11), Chinese Academy of Medical Sciences, Beijing, China.
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47
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Ghazwani Y, Patay Z, Sadighi ZS, Sparrow J, Upadhyaya S, Boop F, Gajjar A, Qaddoumi I. Handedness switching as a presenting sign for pediatric low-grade gliomas: An insight into brain plasticity from a short case series. J Pediatr Rehabil Med 2021; 14:31-36. [PMID: 33386828 DOI: 10.3233/prm-190637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To describe clinical data, rehabilitation services, and outcomes of children with handedness switching as their presenting symptom before low-grade glioma (LGG) diagnosis. METHODS A retrospective chart review was performed for five patients (four female and four white) with LGG and confirmed handedness switching before LGG diagnosis. RESULTS All children were less than 8 years at diagnosis, and two patients were less than 3 years. All children were initially right-handed and experienced loss of motor function, ranging from weakness to paresis, in their dominant hand. The median time from switching handedness to diagnosis was 1 month (range: 0.75-60 months). Rehabilitation was offered for three patients, and motor function deficits in the initial dominant hand were resolved in two of the total cohort. At long-term follow-up, hand dominance returned to the initial hand in three patients. CONCLUSIONS Handedness switching should be acknowledged as a potential sign of LGG in children, and early long-term rehabilitation services should be offered for these children.
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Affiliation(s)
- Yahya Ghazwani
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Zoltan Patay
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Zsila S Sadighi
- Department of Neurology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jessica Sparrow
- Department of Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Santhosh Upadhyaya
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Frederick Boop
- Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Amar Gajjar
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Ibrahim Qaddoumi
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
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48
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Amoruso L, Geng S, Molinaro N, Timofeeva P, Gisbert-Muñoz S, Gil-Robles S, Pomposo I, Quiñones I, Carreiras M. Oscillatory and structural signatures of language plasticity in brain tumor patients: A longitudinal study. Hum Brain Mapp 2020; 42:1777-1793. [PMID: 33368838 PMCID: PMC7978121 DOI: 10.1002/hbm.25328] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 12/12/2020] [Accepted: 12/14/2020] [Indexed: 12/29/2022] Open
Abstract
Recent evidence suggests that damage to the language network triggers its functional reorganization. Yet, the spectro‐temporal fingerprints of this plastic rearrangement and its relation to anatomical changes is less well understood. Here, we combined magnetoencephalographic recordings with a proxy measure of white matter to investigate oscillatory activity supporting language plasticity and its relation to structural reshaping. First, cortical dynamics were acquired in a group of healthy controls during object and action naming. Results showed segregated beta (13–28 Hz) power decreases in left ventral and dorsal pathways, in a time‐window associated to lexico‐semantic processing (~250–500 ms). Six patients with left tumors invading either ventral or dorsal regions performed the same naming task before and 3 months after surgery for tumor resection. When longitudinally comparing patients' responses we found beta compensation mimicking the category‐based segregation showed by controls, with ventral and dorsal damage leading to selective compensation for object and action naming, respectively. At the structural level, all patients showed preoperative changes in white matter tracts possibly linked to plasticity triggered by tumor growth. Furthermore, in some patients, structural changes were also evident after surgery and showed associations with longitudinal changes in beta power lateralization toward the contralesional hemisphere. Overall, our findings support the existence of anatomo‐functional dependencies in language reorganization and highlight the potential role of oscillatory markers in tracking longitudinal plasticity in brain tumor patients. By doing so, they provide valuable information for mapping preoperative and postoperative neural reshaping and plan surgical strategies to preserve language function and patient's quality of life.
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Affiliation(s)
- Lucia Amoruso
- Basque Center on Cognition, Brain and Language (BCBL), San Sebastian, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Shuang Geng
- Basque Center on Cognition, Brain and Language (BCBL), San Sebastian, Spain.,University of the Basque Country, UPV/EHU, Bilbao, Spain
| | - Nicola Molinaro
- Basque Center on Cognition, Brain and Language (BCBL), San Sebastian, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Polina Timofeeva
- Basque Center on Cognition, Brain and Language (BCBL), San Sebastian, Spain.,University of the Basque Country, UPV/EHU, Bilbao, Spain
| | - Sandra Gisbert-Muñoz
- Basque Center on Cognition, Brain and Language (BCBL), San Sebastian, Spain.,University of the Basque Country, UPV/EHU, Bilbao, Spain
| | - Santiago Gil-Robles
- Department of Neurosurgery, Hospital Quiron, Madrid, Spain.,BioCruces Research Institute, Bilbao, Spain
| | | | - Ileana Quiñones
- Basque Center on Cognition, Brain and Language (BCBL), San Sebastian, Spain
| | - Manuel Carreiras
- Basque Center on Cognition, Brain and Language (BCBL), San Sebastian, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain.,University of the Basque Country, UPV/EHU, Bilbao, Spain
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49
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Zhang Z, Jin Z, Yang X, Zhang L, Zhang Y, Liu D, Chi X, Hao S, Feng J, Ji N. Pre-operative Neurocognitive Function Was More Susceptible to Decline in Isocitrate Dehydrogenase Wild-Type Subgroups of Lower-Grade Glioma Patients. Front Neurol 2020; 11:591615. [PMID: 33363506 PMCID: PMC7752952 DOI: 10.3389/fneur.2020.591615] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/18/2020] [Indexed: 12/25/2022] Open
Abstract
Background: Neuropsychological deficits frequently occur in diffuse lower-grade glioma (DLGG) patients, but their relationship with molecular subgroups based on the 2016 World Health Organization (WHO) Classification of Tumors of the Central Nervous System (CNS) is unclear. Methods: All patients enrolled for this study were divided into different subgroups according to the molecular-integrated 2016 CNS WHO and morphology-centric 2007 CNS WHO to compare their neurocognitive function (NCF) dysfunction. Univariate and multivariate analyses were used to assess the independent factors for NCF decline. The performance of NCF changes for discrimination of IDH and 1p19q status was evaluated by receiver operating characteristic (ROC). Results: There was no significant difference in the clinical characteristics among the molecular and morphologic subgroups. In the molecular subgroups, significant differences in NCF alterations were found in terms of attention function, working memory and executive function in grade II glioma patients; in addition to these changes in NCF, memory function and abstract thinking were also significantly different in grade III glioma patients. The pairwise comparison further confirmed that patients with astrocytoma (A)/anaplastic astrocytoma (AA) with isocitrate dehydrogenase wild-type (IDHwt) glioma were more susceptible to severe cognitive decline in terms of the NCF performance described above. For the morphologic subgroups, only working memory was significantly different in grade III glioma patients. The distribution proportion was significantly different among each subgroup of DLGG (grade II, P = 0.001; grade III, P = 0.002). The proportion of extensive NCF decline (≥5 tests) was 4, 12, and 50% in the IDH mutant oligodendroglioma (IDHm-O), IDHm-A, and IDHwt-A subgroups, and this proportion was 33, 60, and 93% in the IDHm-AO, IDHm-AA, and IDHwt-AA subgroups, respectively. In multivariate regression analysis, molecular types were independent factors for NCF alterations after adjusted the factors of tumor and demographics (p < 0.05). ROC curves suggested combined NCF tests model showed an advantage in the differentiation of IDH status. Conclusions: NCF alteration is closely related to molecular-integrated subgroups with varying degrees and frequencies in DLGG. Patients with IDHwt gliomas are more susceptible to suffer from severe and extensive NCF decline than other subgroups.
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Affiliation(s)
- Zhe Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases (China), Beijing, China
| | - Zeping Jin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases (China), Beijing, China
| | - Xiaojie Yang
- Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Liang Zhang
- Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yang Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases (China), Beijing, China
| | - Dayuan Liu
- Department of Neurosurgery, The Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Xiaohan Chi
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases (China), Beijing, China
| | - Shuyu Hao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases (China), Beijing, China
| | - Jie Feng
- National Clinical Research Center for Neurological Diseases (China), Beijing, China.,Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Cancer Institute, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Nan Ji
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Neurological Diseases (China), Beijing, China.,Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing, China
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50
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Cargnelutti E, Ius T, Skrap M, Tomasino B. What do we know about pre- and postoperative plasticity in patients with glioma? A review of neuroimaging and intraoperative mapping studies. NEUROIMAGE-CLINICAL 2020; 28:102435. [PMID: 32980599 PMCID: PMC7522801 DOI: 10.1016/j.nicl.2020.102435] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 09/08/2020] [Accepted: 09/11/2020] [Indexed: 02/06/2023]
Abstract
Brain reorganization can take place before and after surgery of low- and high-grade gliomas. Plasticity is observed for low-grade but also for high-grade gliomas. The contralesional hemisphere can be vital for successful compensation. There is evidence of plasticity for both the language system and the sensorimotor system. Partial compensation can also occur at the white-matter level. Subcortical connectivity is crucial for brain reorganization.
Brain plasticity potential is a central theme in neuro-oncology and is currently receiving increased attention. Advances in treatment have prolonged life expectancy in neuro-oncological patients and the long-term preservation of their quality of life is, therefore, a new challenge. To this end, a better understanding of brain plasticity mechanisms is vital as it can help prevent permanent deficits following neurosurgery. Indeed, reorganization processes can be fundamental to prevent or recover neurological and cognitive deficits by reallocating brain functions outside the lesioned areas. According to more recent studies in the literature, brain reorganization taking place following neurosurgery is associated with good neurofunctioning at follow-up. Interestingly, in the last few years, the number of reports on plasticity has notably increased. Aim of the current review was to provide a comprehensive overview of pre- and postoperative neuroplasticity patterns. Within this framework, we aimed to shed light on some tricky issues, including i) involvement of the contralateral healthy hemisphere, ii) role and potential changes of white matter and connectivity patterns, and iii) reorganization in low- versus high-grade gliomas. We finally discussed the practical implications of these aspects and role of additional potentially relevant factors to be explored. Final purpose was to provide a guideline helpful in promoting increase in the extent of tumor resection while preserving the patients’ neurological and cognitive functioning.
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Affiliation(s)
- Elisa Cargnelutti
- Scientific Institute, IRCCS E. Medea, Dipartimento/Unità Operativa Pasian di Prato, Udine, Italy
| | - Tamara Ius
- SOC Neurochirurgia, Azienda Sanitaria Universitaria Friuli Centrale ASU FC, Italy
| | - Miran Skrap
- SOC Neurochirurgia, Azienda Sanitaria Universitaria Friuli Centrale ASU FC, Italy
| | - Barbara Tomasino
- Scientific Institute, IRCCS E. Medea, Dipartimento/Unità Operativa Pasian di Prato, Udine, Italy.
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